Wang Fangzheng, Jiang Chuner, Ye Zhimin, Sun Quanquan, Liu Tongxin, Xu Min, Wu Peng, Shi Kaiyuan, Long Bin, Rihito Aizawa, Masoto Sakamoto, Fu Zhenfu
Department of Radiation Oncology, Zhejiang Cancer Hospital, Zhejiang Hangzhou, People's Republic of China.
Zhejiang Key Laboratory of Radiation Oncology, Zhejiang Hangzhou, People's Republic of China.
Oncotarget. 2017 Apr 21;8(43):75544-75556. doi: 10.18632/oncotarget.17357. eCollection 2017 Sep 26.
We assessed the efficacy and safety of nimotuzumab plus neoadjuvant chemotherapy followed by concurrent chemoradiotherapy for Chinese patients with locoregionally advanced nasopharyngeal carcinoma. Clinical data from 210 nonmetastatic nasopharyngeal carcinoma patients diagnosed between May 2008 and April 2014 were retrospectively reviewed. All patients were initially treated with nimotuzumab plus neoadjuvant chemotherapy followed by concurrent chemoradiotherapy. Ninety-five patients received cisplatin-based adjuvant chemotherapy. The median follow-up duration was 48 months. Locoregional relapse and distant metastases occurred in 16 patients (16/210, 7.6%) and 18 patients (18/210, 8.6%), respectively. The 5-year local recurrence-free survival, regional recurrence-free survival, distant metastases-free survival, progression-free survival, and overall survival rates were 95.6%, 94.4%, 91.7%, 84.0%, and 88.7%, respectively. Univariate analysis revealed that concurrent chemotherapy regimens and clinical stage correlated with overall survival, and that adjuvant chemotherapy, N stage, clinical stage, and tumor response at the end of treatment were correlated with progression-free survival. In the multivariate analysis, concurrent chemotherapy regimens, clinical stage, and tumor response were important prognosticators. Grade 3/4 leukocytopenia was experienced by 24 patients (11.4%), and 6 patients (2.9%) developed mild liver damage during the period of neoadjuvant chemotherapy. Grade 3/4 acute mucositis was experienced by 13 patients (6.2%), and 12 patients (5.7%) experienced grade 3/4 leukocytopenia during the concurrent chemotherapy. The efficacy of nimotuzumab plus neoadjuvant chemotherapy followed by concurrent chemotherapy in locoregionally advanced nasopharyngeal carcinoma patients was encouraging and the toxicities were tolerable.
我们评估了尼妥珠单抗联合新辅助化疗后序贯同步放化疗方案对中国局部区域晚期鼻咽癌患者的疗效和安全性。回顾性分析了2008年5月至2014年4月期间确诊的210例非转移性鼻咽癌患者的临床资料。所有患者均首先接受尼妥珠单抗联合新辅助化疗，随后进行同步放化疗。95例患者接受了以顺铂为基础的辅助化疗。中位随访时间为48个月。局部区域复发和远处转移分别发生在16例患者（16/210，7.6%）和18例患者（18/210，8.6%）中。5年局部无复发生存率、区域无复发生存率、远处转移无复发生存率、无进展生存率和总生存率分别为95.6%、94.4%、91.7%、84.0%和88.7%。单因素分析显示，同步化疗方案和临床分期与总生存相关，辅助化疗、N分期、临床分期和治疗结束时的肿瘤反应与无进展生存相关。多因素分析中，同步化疗方案、临床分期和肿瘤反应是重要的预后因素。24例患者（11.4%）出现3/4级白细胞减少，6例患者（2.9%）在新辅助化疗期间出现轻度肝损伤。13例患者（6.2%）出现3/4级急性黏膜炎，12例患者（5.7%）在同步化疗期间出现3/4级白细胞减少。尼妥珠单抗联合新辅助化疗后序贯同步放化疗方案在局部区域晚期鼻咽癌患者中的疗效令人鼓舞，毒性反应可耐受。
