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西妥昔单抗联合生物放疗与铂类同步放化疗治疗头颈部鳞状细胞癌的急性毒性比较:日本单机构回顾性研究

Comparison of acute toxicities associated with cetuximab-based bioradiotherapy and platinum-based chemoradiotherapy for head and neck squamous cell carcinomas: A single-institution retrospective study in Japan.

作者信息

Sakashita Tomohiro, Homma Akihiro, Hatakeyama Hiromitsu, Furusawa Jun, Kano Satoshi, Mizumachi Takatsugu, Iizuka Satoshi, Onimaru Rikiya, Tsuchiya Kazuhiko, Yasuda Koichi, Shirato Hiroki, Fukuda Satoshi

机构信息

Department of Otolaryngology-Head & Neck Surgery .

出版信息

Acta Otolaryngol. 2015 Aug;135(8):853-8. doi: 10.3109/00016489.2015.1030772. Epub 2015 Mar 26.

Abstract

CONCLUSION

Grade ≥ 3 mucositis/stomatitis and inability to feed orally were problematic for patients undergoing cetuximab-based bioradiotherapy (BRT) as well as platinum-based chemoradiotherapy (CRT). Severe mucositis/stomatitis and radiation dermatitis should be addressed carefully in patients undergoing cetuximab-based BRT as well.

OBJECTIVES

The efficacy of cetuximab-based BRT in locally advanced head and neck squamous cell carcinomas has been established. However, the safety of cetuximab-based BRT in comparison with platinum-based CRT is currently under investigation.

METHOD

This study retrospectively analyzed 14 patients undergoing cetuximab-based BRT and 29 patients undergoing platinum-based CRT to compare the incidence of acute toxicities. In the BRT group, an initial cetuximab loading dose of 400 mg/m(2) was delivered 1 week before the start of radiotherapy. Seven weekly infusions of 250 mg/m(2) of cetuximab followed during the definitive radiotherapy. In the CRT group, cisplatin was administered at a dose of 40 mg/m(2) weekly during the definitive radiotherapy.

RESULTS

The BRT group had a higher incidence of Grade ≥ 3 radiation dermatitis than did the CRT group (43% vs 3%, respectively, p < 0.01). The incidence rate of Grade ≥ 3 mucositis/stomatitis was 64.3% and 41.4% in the BRT and CRT group, respectively (p = 0.1484), while the incidence rate of the inability to feed orally was 38.5% and 55.2%, respectively (p = 0.2053).

摘要

结论

对于接受基于西妥昔单抗的生物放疗(BRT)以及基于铂类的放化疗(CRT)的患者而言,≥3级黏膜炎/口腔炎以及无法经口进食是棘手的问题。对于接受基于西妥昔单抗的BRT的患者,也应谨慎处理严重的黏膜炎/口腔炎和放射性皮炎。

目的

基于西妥昔单抗的BRT在局部晚期头颈部鳞状细胞癌中的疗效已得到证实。然而,与基于铂类的CRT相比,基于西妥昔单抗的BRT的安全性目前正在研究中。

方法

本研究回顾性分析了14例接受基于西妥昔单抗的BRT的患者和29例接受基于铂类的CRT的患者,以比较急性毒性的发生率。在BRT组中,放疗开始前1周给予初始西妥昔单抗负荷剂量400mg/m²。在根治性放疗期间,随后每周输注7次250mg/m²的西妥昔单抗。在CRT组中,在根治性放疗期间每周给予顺铂剂量为40mg/m²。

结果

BRT组≥3级放射性皮炎的发生率高于CRT组(分别为43%和3%,p<0.01)。BRT组和CRT组≥3级黏膜炎/口腔炎的发生率分别为64.3%和41.4%(p=0.1484),而无法经口进食的发生率分别为38.5%和55.2%(p=0.2053)。

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