Kang Min, Wang Fangfang, Liao Xueyin, Zhou Pingting, Wang Rensheng
Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University; Guangxi Tumor Radiation Therapy Clinical Medical Research Center, Nanning Department of Radiation Oncology, First People's Hospital of Beihai City, Beihai, Guangxi, PR China.
Medicine (Baltimore). 2018 Jun;97(25):e11118. doi: 10.1097/MD.0000000000011118.
The present study is to compare the efficacy and adverse effects of intensity-modulated radiotherapy (IMRT) combined with endostar and IMRT combined with concurrent chemotherapy on locally advanced nasopharyngeal carcinoma (NPC).A total of 23 patients with stage III-IVa NPC were included in the present study, and randomly divided into experimental group (10 cases treated with IMRT + endostar) and control group (13 cases treated with IMRT + chemotherapy of cis-dichlorodiamineplatinum). Endostar was intravenously administered from the first day of IMRT. The patients received a total of 2 cycles (14 days each) separating by a 7-day interval.IMRT combined with endostar did not have significantly different recent efficacy compared with IMRT combined with chemotherapy. IMRT combined with endostar and IMRT combined with chemotherapy had 2-year overall survival (OS) rates of 100.0% and 69.6%, respectively, without significant difference between each other (χ = 1.446, P = .299). The 2-year local relapse-free survival (LRFS) of the 2 groups were 100.0% and 81.3%, respectively, without significant difference between each other (χ = 1.000, P = .317). The 2-year distant metastasis-free survival (DMFS) of the 2 groups were 100.0% and 73.5% (χ = 1.591, P = .207), respectively. The 2-year progression-free survival (PFS) of the 2 groups were 100.0% and 67.3% (χ = 2.164, P = .141), respectively. However, the cumulative survival curves of OS, LRFS, DMFS, and PFS were separated between the 2 groups. The result that IMRT combined with endostar did not have significantly different long-term efficacy than IMRT combined with chemotherapy probably due to limited case number and short follow-up time. IMRT combined with endostar resulted in significantly lower grades of leucopenia, nausea/vomiting, weight loss, and oral mucositis compared with IMRT combined with chemotherapy. The grades of late adverse reactions of IMRT combined with endostar were not different from those of IMRT combined with chemotherapy.The present study demonstrates that, compared with IMRT combined with chemotherapy, IMRT combined with endostar has similar efficacy in the treatment of locally advanced NPC, but significantly weaker acute adverse reactions, which improve the life quality of NPC patients.
本研究旨在比较调强放射治疗（IMRT）联合恩度与IMRT联合同期化疗治疗局部晚期鼻咽癌（NPC）的疗效和不良反应。本研究共纳入23例III-IVa期NPC患者，随机分为实验组（10例接受IMRT + 恩度治疗）和对照组（13例接受IMRT + 顺铂化疗）。恩度于IMRT第1天开始静脉给药。患者共接受2个周期（每个周期14天），间隔7天。IMRT联合恩度与IMRT联合化疗的近期疗效无显著差异。IMRT联合恩度与IMRT联合化疗的2年总生存率（OS）分别为100.0%和69.6%，两者之间无显著差异（χ = 1.446，P = .299）。两组的2年局部无复发生存率（LRFS）分别为100.0%和81.3%，两者之间无显著差异（χ = 1.000，P = .317）。两组的2年远处无转移生存率（DMFS）分别为100.0%和73.5%（χ = 1.591，P = .207）。两组的2年无进展生存率（PFS）分别为100.0%和67.3%（χ = 2.164，P = .141）。然而，两组的OS、LRFS、DMFS和PFS的累积生存曲线是分开的。IMRT联合恩度与IMRT联合化疗的长期疗效无显著差异，可能是由于病例数有限和随访时间短。与IMRT联合化疗相比，IMRT联合恩度导致白细胞减少、恶心/呕吐、体重减轻和口腔黏膜炎的程度显著更低。IMRT联合恩度的晚期不良反应程度与IMRT联合化疗无差异。本研究表明，与IMRT联合化疗相比，IMRT联合恩度在治疗局部晚期NPC方面具有相似的疗效，但急性不良反应明显较弱，这提高了NPC患者的生活质量。
