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调强放疗联合或不联合尼妥珠单抗治疗 III-IVb 期鼻咽癌患者的长期生存:倾向评分匹配分析。

The long-term survival of patients with III-IVb stage nasopharyngeal carcinoma treated with IMRT with or without Nimotuzumab: a propensity score-matched analysis.

机构信息

State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.

Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China.

出版信息

BMC Cancer. 2019 Nov 19;19(1):1122. doi: 10.1186/s12885-019-6156-5.

Abstract

BACKGROUND

To assess the efficacy of Nimotuzumab in combination with first-line chemoradiotherapy treatment in Chinese patients with primary III-IVb stage nasopharyngeal carcinoma.

METHODS

Patients with primary locoregionally advanced nasopharyngeal carcinoma who were treated with intensity-modulated radiotherapy (IMRT) and concurrent cisplatin-based chemotherapy between January 2008 and December 2013 at a single institution were retrospectively reviewed. Group A received at least 6 doses of Nimotuzumab, while Group B did not receive Nimotuzumab. A propensity score matching method was used to match patients from each group in a 1:3 ratio.

RESULTS

In total, 730 eligible patients were propensity matched, with 184 patients in Group A and 546 patients in Group B. Significant differences were not observed in the patient and tumor characteristics between Group A and Group B. At a median follow-up of 74.78 months (range 3.53-117.83 months), locoregional recurrence, distant failure and death were observed in 10.68, 11.10 and 16.03% of all patients, respectively. The estimated 5-year locoregional relapse-free survival, distant metastasis-free survival, progression-free survival and overall survival in the Group A versus Group B were 85.34% versus 89.79% (P = 0.156), 93.09% versus 85.61% (P = 0.012), 79.96% versus 77.99% (P = 0.117) and 88.91% versus 78.30% (P = 0.006), respectively.

CONCLUSIONS

This nimotuzumab-containing regimen resulted in improved long-term survival of III-IVb stage NPC patients and warrants further prospective evaluation.

摘要

背景

评估尼妥珠单抗联合一线放化疗治疗中国初治 III-IVb 期鼻咽癌患者的疗效。

方法

回顾性分析 2008 年 1 月至 2013 年 12 月期间,在一家单中心接受调强放疗(IMRT)联合顺铂类同期化疗的初治局部晚期鼻咽癌患者。A 组至少接受 6 个疗程的尼妥珠单抗,B 组未接受尼妥珠单抗。采用倾向评分匹配方法,将每组患者按 1:3 比例匹配。

结果

共纳入 730 例符合条件的患者进行倾向评分匹配,A 组 184 例,B 组 546 例。A 组和 B 组患者和肿瘤特征无显著差异。中位随访 74.78 个月(范围 3.53-117.83 个月),所有患者局部区域复发、远处转移和死亡的发生率分别为 10.68%、11.10%和 16.03%。A 组与 B 组患者的 5 年局部区域无复发生存率、远处无转移生存率、无进展生存率和总生存率分别为 85.34%与 89.79%(P=0.156)、93.09%与 85.61%(P=0.012)、79.96%与 77.99%(P=0.117)和 88.91%与 78.30%(P=0.006)。

结论

该尼妥珠单抗方案可改善 III-IVb 期 NPC 患者的长期生存,值得进一步前瞻性评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a437/6862826/37545d94be6b/12885_2019_6156_Fig1_HTML.jpg

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