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西妥昔单抗同步放化疗治疗局部晚期鼻咽癌的毒性反应

Toxicity of concurrent chemoradiotherapy with cetuximab for locoregionally advanced nasopharyngeal carcinoma.

作者信息

Feng Hui-Xia, Guo Su-Ping, Li Gui-Rong, Zhong Wen-Huan, Chen Liu, Huang Li-Ru, Qin Hui-Ying

机构信息

Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China.

出版信息

Med Oncol. 2014 Sep;31(9):170. doi: 10.1007/s12032-014-0170-x. Epub 2014 Aug 15.

Abstract

Overexpression of the epidermal growth factor receptor can be found in 80 % of patients with locoregionally advanced nasopharyngeal carcinoma (NPC) and is associated with shorter survival. In this work, we evaluated the feasibility of adding cetuximab to concurrent cisplatin and radiotherapy (RT) in locoregionally advanced NPC. Twenty-eight patients with locoregionally advanced NPC who received the combination therapy were retrospectively reviewed and short-term efficacy was evaluated. Grade 3-4 oral mucositis occurred in 20 (71.4 %) patients. Grade 3 radiotherapy-related dermatitis occurred in seven patients (25 %). Three patients (14.3 %) had grade 3 and one patient (3.6 %) had grade 4 cetuximab-related acneiform rashes. These grade 3-4 skin and mucosal toxic effects were manageable and reversible. At a median follow-up of 33.4 months (95 % CI 29.2-38.1 months), the 2-year progression-free survival was 89.3 % (95 % CI 76.4-98.1 %). In conclusion, concurrent administration of cetuximab, cisplatin and RT is a feasible strategy against locoregionally advanced NPC. Preliminary survival data compare favorably with historic data and further follow-up is warranted.

摘要

在80%的局部区域晚期鼻咽癌(NPC)患者中可发现表皮生长因子受体过表达,且其与较短的生存期相关。在本研究中,我们评估了在局部区域晚期NPC患者中,将西妥昔单抗添加至顺铂同步放疗(RT)方案中的可行性。对28例接受联合治疗的局部区域晚期NPC患者进行回顾性分析,并评估短期疗效。20例(71.4%)患者发生3-4级口腔黏膜炎。7例患者(25%)发生3级放疗相关皮炎。3例患者(14.3%)出现3级,1例患者(3.6%)出现4级西妥昔单抗相关的痤疮样皮疹。这些3-4级皮肤和黏膜毒性反应是可控且可逆的。中位随访33.4个月(95%CI 29.2-38.1个月)时,2年无进展生存率为89.3%(95%CI 76.4-98.1%)。总之,西妥昔单抗、顺铂和RT同步应用是治疗局部区域晚期NPC的一种可行策略。初步生存数据与既往数据相比具有优势,有必要进行进一步随访。

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