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西妥昔单抗联合放化疗治疗不可切除局部晚期食管鳞癌中国患者的前瞻性多中心Ⅱ期研究

Cetuximab in combination with chemoradiotherapy in Chinese patients with non-resectable, locally advanced esophageal squamous cell carcinoma: a prospective, multicenter phase II trail.

机构信息

Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, China.

出版信息

Radiother Oncol. 2013 Nov;109(2):275-80. doi: 10.1016/j.radonc.2013.09.008. Epub 2013 Oct 12.

Abstract

BACKGROUND AND PURPOSE

This multicenter phase II trial investigated cetuximab combined with chemoradiotherapy in patients with esophageal squamous cell carcinoma (ESCC).

MATERIAL AND METHODS

Eligible patients with non-resectable, locally-advanced ESCC received cetuximab 400mg/m(2) loading dose on day 1; and on day 1 of the 2nd-7th weeks: cetuximab 250mg/m(2), paclitaxel 45mg/m(2), and cisplatin 20mg/m(2), concurrent with 59.4Gy/33 fractions of radiation therapy. Primary endpoint was clinical response rate. Secondary endpoints included overall survival (OS), progression-free survival (PFS), safety, and KRAS status.

RESULTS

Of 55 patients enrolled, 45 completed therapy. Forty-four patients had a clinical response: 29 complete response and 15 partial response. One-year PFS and OS of 45 evaluable patients were 84.23% and 93.33%, respectively, and 2-year PFS and OS were 74.87% and 80.00%, respectively. Non-hematologic adverse events were generally grade 1 or 2; primarily rash (92.7%), mucositis (45.5%), fatigue (41.8%), and nausea (38.2%). Grade 3 hematologic adverse events included neutropenia (32.7%) and anemia (1.8%). No KRAS mutations were identified in 50 evaluated samples.

CONCLUSIONS

Cetuximab can be safely administered with chemoradiotherapy to patients with locally-advanced ESCC and may improve clinical response rate.

摘要

背景与目的

本多中心 II 期临床试验旨在研究西妥昔单抗联合放化疗治疗食管鳞癌(ESCC)。

材料与方法

纳入的不可切除、局部晚期 ESCC 患者接受西妥昔单抗 400mg/m²负荷剂量,第 1 天;第 2-7 周第 1 天:西妥昔单抗 250mg/m²,紫杉醇 45mg/m²,顺铂 20mg/m²,同时接受 59.4Gy/33 次放疗。主要终点为临床缓解率。次要终点包括总生存期(OS)、无进展生存期(PFS)、安全性和 KRAS 状态。

结果

55 例患者中,45 例完成治疗。44 例患者有临床缓解:29 例完全缓解,15 例部分缓解。45 例可评估患者的 1 年 PFS 和 OS 分别为 84.23%和 93.33%,2 年 PFS 和 OS 分别为 74.87%和 80.00%。非血液学不良事件一般为 1 级或 2 级;主要为皮疹(92.7%)、黏膜炎(45.5%)、乏力(41.8%)和恶心(38.2%)。3 级血液学不良事件包括中性粒细胞减少(32.7%)和贫血(1.8%)。50 例评估样本中未发现 KRAS 突变。

结论

西妥昔单抗联合放化疗治疗局部晚期 ESCC 安全有效,可能提高临床缓解率。

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