Department of Otorhinolaryngology/Head and Neck Surgery, General Hospital of Ningxia Medical University, Yinchuan, China.
J BUON. 2021 Jan-Feb;26(1):138-144.
To explore the efficacy and safety of cetuximab combined with intensity-modulated radiotherapy (IMRT) and concurrent cisplatin-based chemotherapy in the treatment of patients with locally advanced nasopharyngeal carcinoma.
The clinical information of 126 patients with locally advanced nasopharyngeal carcinoma, who were admitted to and treated in our department from September 2013 to May 2016, was collected, and they were randomly divided into two groups: cetuximab combined with IMRT and concurrent cisplatin-based chemotherapy group (Cetuximab group, n=63) and IMRT combined with concurrent cisplatin-based chemotherapy group (Control group, n=63). The clinical efficacy, changes in patients' quality of life and incidence of adverse reactions were observed and compared between the two groups, and the tumor progression and survival of the patients were followed up and recorded.
The patients in Cetuximab group exhibited substantially higher objective remission rate (ORR) and disease control rate (DCR) [90.5% (57/63) and 100%] than those in Control group [71.4% (46/63) and 88.9% (56/63)] (p=0.011 and 0.007). After treatment, the physiological status, social and familial status and emotional status based on the FACT-H&N scale were not statistically significantly different between the two groups of patients, but the patients in Cetuximab group had notably superior functional status, additional items for the head and neck and total scale score to those in Control group (p=0.011, 0.021 and 0.038). Additionally, the main adverse reactions of patient after treatment included myelosuppression, fever, gastrointestinal reactions, acne-like rash, radiodermatitis, oral mucositis, and liver and kidney function impairment, most of which were in grade I-II (p>0.05), and the differences between the two groups were not statistically significant (p>0.05). According to the log-rank test, the differences in the OS and PFS of patients between the two groups were not statistically significant (p=0.411 and 0.114).
Cetuximab combined with IMRT and concurrent cisplatin-based chemotherapy has better clinical short-term efficacy in treating locally advanced nasopharyngeal carcinoma, and the patients treated have improved quality of life and can tolerate adverse reactions.
探索西妥昔单抗联合调强放疗（IMRT）和顺铂为基础的同期化疗治疗局部晚期鼻咽癌的疗效和安全性。
收集 2013 年 9 月至 2016 年 5 月在我科住院并接受治疗的 126 例局部晚期鼻咽癌患者的临床资料，采用随机数字表法将患者分为西妥昔单抗联合 IMRT 和顺铂为基础的同期化疗组（西妥昔单抗组，n=63）和 IMRT 联合顺铂为基础的同期化疗组（对照组，n=63）。观察并比较两组患者的临床疗效、生活质量变化及不良反应发生率，随访并记录患者的肿瘤进展和生存情况。
西妥昔单抗组患者的客观缓解率（ORR）和疾病控制率（DCR）明显高于对照组[90.5%（57/63）和 100%比 71.4%（46/63）和 88.9%（56/63）]（p=0.011 和 0.007）。治疗后，基于 FACT-H&N 量表的患者生理状况、社会和家庭状况以及情绪状况评分在两组间无统计学差异，但西妥昔单抗组患者的功能状况、头颈部附加项目和总评分均明显优于对照组（p=0.011、0.021 和 0.038）。此外，患者治疗后的主要不良反应包括骨髓抑制、发热、胃肠道反应、痤疮样皮疹、放射性皮炎、口腔黏膜炎和肝肾功能损害，多为 1~2 级（p>0.05），两组间差异无统计学意义（p>0.05）。根据对数秩检验，两组患者的 OS 和 PFS 差异无统计学意义（p=0.411 和 0.114）。
西妥昔单抗联合 IMRT 和顺铂为基础的同期化疗治疗局部晚期鼻咽癌具有更好的临床近期疗效，且患者生活质量改善，能耐受不良反应。
