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以 nab-紫杉醇为基础的诱导化疗联合或不联合西妥昔单抗治疗局部晚期头颈部鳞状细胞癌。

nab-Paclitaxel-based induction chemotherapy with or without cetuximab for locally advanced head and neck squamous cell carcinoma.

机构信息

Division of Medical Oncology, Washington University School of Medicine, St. Louis, MO, United States; Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, United States.

Division of Medical Oncology, Washington University School of Medicine, St. Louis, MO, United States.

出版信息

Oral Oncol. 2017 Sep;72:26-31. doi: 10.1016/j.oraloncology.2017.07.001. Epub 2017 Jul 8.

Abstract

OBJECTIVES

To explore the effect of incorporating cetuximab into induction chemotherapy in locally advanced head and neck squamous cell carcinoma (HNSCC).

MATERIALS AND METHODS

Retrospective comparative analysis of two consecutive prospective phase II trials was performed: trial 1 with nab-paclitaxel/cisplatin/5-FU and cetuximab (APF-C; n=30) and trial 2 with APF (n=30). Patients were scheduled to receive chemoradiation therapy (CRT) with cisplatin. T classification oropharynx (OP)/larynx/hypopharynx SCC were included. Cumulative incidence of death of disease (CIDD), overall survival (OS), and cumulative incidence of relapse were compared between APF-C and APF.

RESULTS

No significant differences in patient or tumor characteristics were noted between the groups. Median follow-up of surviving patients was 52 (25-95) months. Relapse occurred in 5 (17%) patients treated with APF-C and in 2 (7%) treated with APF (p=0.37). In human papillomavirus (HPV)-related OPSCC (n=34), the CIDD at 52months was 3.4% with APF-C and 2.6% with APF and the two-year OSs were 94%. In HPV-unrelated HNSCC (n=25), the CIDD at 52months was 4.4% with APF-C and 3.3% with APF and two-year OSs were 83% and 92%, respectively. CIDD or OS did not differ when stratified by treatment group and HPV status (CIDD: p=0.80; OS: p=0.30).

CONCLUSION

This exploratory retrospective comparative analysis demonstrated no significant difference in CIDD, OS, or cumulative incidence of relapse between patients treated with APF-C or APF.

摘要

目的

探索在局部晚期头颈部鳞状细胞癌(HNSCC)中加入西妥昔单抗进行诱导化疗的效果。

材料与方法

对两项连续前瞻性 II 期试验进行回顾性对比分析:试验 1 采用nab-紫杉醇/顺铂/5-FU 联合西妥昔单抗(APF-C;n=30),试验 2 采用 APF(n=30)。患者计划接受含顺铂的放化疗。纳入 T 分类口咽(OP)/喉/下咽 SCC 患者。比较 APF-C 和 APF 组的疾病死亡累积发生率(CIDD)、总生存率(OS)和复发累积发生率。

结果

两组患者或肿瘤特征无显著差异。存活患者的中位随访时间为 52(25-95)个月。APF-C 组有 5(17%)例患者复发,APF 组有 2(7%)例患者复发(p=0.37)。在人乳头瘤病毒(HPV)相关 OP 癌(n=34)中,APF-C 的 52 个月 CIDD 为 3.4%,APF 的为 2.6%,两年 OS 分别为 94%。在 HPV 无关的 HNSCC(n=25)中,APF-C 的 52 个月 CIDD 为 4.4%,APF 的为 3.3%,两年 OS 分别为 83%和 92%。分层比较治疗组和 HPV 状态后,CIDD 或 OS 无差异(CIDD:p=0.80;OS:p=0.30)。

结论

这项探索性回顾性对比分析表明,APF-C 或 APF 治疗的患者之间,CIDD、OS 或复发累积发生率无显著差异。

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