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放疗联合尼妥珠单抗对比放化疗治疗局部复发性鼻咽癌的疗效比较。

Comparison of radiotherapy combined with nimotuzumab vs. chemoradiotherapy for locally recurrent nasopharyngeal carcinoma.

机构信息

Department of Radiation Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, No. 420 Fuma Road, Fuzhou, 350014, Fujian, China.

Fujian Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China.

出版信息

BMC Cancer. 2021 Nov 25;21(1):1274. doi: 10.1186/s12885-021-08995-y.

Abstract

BACKGROUND

The present study compared the effectiveness and toxicity of two treatment modalities, namely radiotherapy combined with nimotuzumab (N) and chemoradiotherapy (CRT) in patients with locally recurrent nasopharyngeal carcinoma (LR-NPC).

METHODS

Patients with LR-NPC who were treated with radiotherapy were retrospectively enrolled from January 2015 to December 2018. The treatment included radiotherapy combined with N or platinum-based induction chemotherapy and/or concurrent chemotherapy. The comparison of survival and toxicity between the two treatment modalities was evaluated using the log-rank and chi-squared tests. Overall survival (OS) was the primary endpoint.

RESULTS

A total of 87 patients were included, of whom 32 and 55 were divided into the N group and the CRT group, respectively. No significant differences were noted in the survival rate between the N and the CRT groups (4-year OS rates, 37.1% vs. 40.7%, respectively; P = 0.735). Mild to moderate acute complications were common during the radiation period and mainly included mucositis and xerostomia. The majority of the acute toxic reactions were tolerated well. A total of 48 patients (55.2%) demonstrated late radiation injuries of grade ≥ 3, including 12 patients (37.5%) in the N group and 36 patients (66.5%) in the CRT group. The CRT group exhibited significantly higher incidence of severe late radiation injuries compared with that of the N group (P = 0.011).

CONCLUSION

Radiotherapy combined with N did not appear to enhance treatment efficacy compared with CRT in patients with LR-NPC. However, radiotherapy combined with N may be superior to CRT due to its lower incidence of acute and late toxicities. Further studies are required to confirm the current findings.

摘要

背景

本研究比较了两种治疗方式,即放疗联合尼妥珠单抗(N)与放化疗(CRT)在局部复发性鼻咽癌(LR-NPC)患者中的疗效和毒性。

方法

回顾性纳入 2015 年 1 月至 2018 年 12 月接受放疗的 LR-NPC 患者。治疗包括放疗联合 N 或铂类诱导化疗和/或同期化疗。采用对数秩和卡方检验比较两种治疗方式的生存和毒性差异。总生存(OS)为主要终点。

结果

共纳入 87 例患者,其中 32 例和 55 例分别纳入 N 组和 CRT 组。N 组和 CRT 组的生存率无显著差异(4 年 OS 率分别为 37.1%和 40.7%;P=0.735)。放疗期间常见轻中度急性并发症,主要包括黏膜炎和口干。大多数急性毒性反应均能耐受。共有 48 例(55.2%)发生≥3 级迟发性放射性损伤,其中 N 组 12 例(37.5%),CRT 组 36 例(66.5%)。CRT 组迟发性放射性损伤发生率明显高于 N 组(P=0.011)。

结论

放疗联合 N 并未提高 LR-NPC 患者的治疗效果,反而可能因其急性和迟发性毒性发生率较低而优于 CRT。需要进一步研究证实目前的发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c0f/8620547/0f2e19e3b707/12885_2021_8995_Fig1_HTML.jpg

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