Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China; Department of Oncology, Yunfu People's Hospital affiliated to Southern Medical University, Yunfu, China.
Department of Radiation Oncology, First People's Hospital of Beihai City, Beihai, China.
Ann Palliat Med. 2021 Nov;10(11):11891-11900. doi: 10.21037/apm-21-3018.
This study aimed to analyze the long-term efficacy and late adverse reactions of intensity-modulated radiation therapy (IMRT) combined with recombinant human endostatin (Endostar) versus IMRT combined with concurrent chemotherapy (CCT) in patients with locoregionally advanced nasopharyngeal carcinoma (NPC).
This was a retrospective analysis of twenty-three NPC stage III-IVA patients treated with IMRT + Endostar or IMRT + CCT. Patients in the IMRT + Endostar group (n=10) received a total of 2 cycles of Endostar, while patients in the IMRT + CCT group (n=13) received a total of 3 cycles of concurrent cisplatin chemotherapy.
The 5-year overall survival rates (OS) for the IMRT + Endostar group and the IMRT + CCT group were 90.0% and 61.5% P=0.123), respectively. Local relapse-free survival (LRFS) rates were 90.0% and 76.9% (P=0.396), distant metastasis-free survival (DMFS) rates were 90.0% and 61.5% (P=0.129), and progression-free survival (PFS) rates were 90.0% and 53.8% (P=0.074) for the IMRT + Endostar group and the IMRT + CCT group. The incidence of grades 0, 1, and 2 xerostomia was 70.0%, 20.0%, and 10.0%, respectively, in the IMRT + Endostar group, and 15.4%, 76.9%, and 7.7% in the IMRT + CCT group, showing significant differences between the 2 groups (P=0.020). For the IMRT + Endostar group, the incidence of grades 0, 1, and 2 mouth-opening difficulty was 100.0%, 0%, and 0%, respectively, while for the IMRT + CCT group, the incidence was 53.8%, 38.5%, and 7.7%, with significant differences between the two groups (P=0.044). For the IMRT + Endostar group, the incidence of grades 0, 1, and 2 cervical and facial soft tissue fibrosis was 40.0%, 60.0%, and 0%, respectively, while for the IMRT + CCT group, the incidence was 0%, 76.9%, and 23.1%, showing significant differences between the two groups (P=0.027).
The difference in long-term efficacy between the IMRT + Endostar group and IMRT + CCT group was not significant for locally advanced NPC, but the IMRT + Endostar group had better efficacy and less severe late side effects. Further research involving a larger sample size and longer follow-up period are needed.
本研究旨在分析调强放疗（IMRT）联合重组人血管内皮抑制素（Endostar）与 IMRT 联合同期化疗（CCT）治疗局部晚期鼻咽癌（NPC）的长期疗效和晚期不良反应。
回顾性分析 23 例 NPC Ⅲ-ⅣA 期患者接受 IMRT+Endostar 或 IMRT+CCT 治疗。IMRT+Endostar 组（n=10）共接受 2 周期 Endostar 治疗，IMRT+CCT 组（n=13）共接受 3 周期同期顺铂化疗。
IMRT+Endostar 组和 IMRT+CCT 组的 5 年总生存率（OS）分别为 90.0%和 61.5%（P=0.123）。局部无复发生存率（LRFS）分别为 90.0%和 76.9%（P=0.396），远处无转移生存率（DMFS）分别为 90.0%和 61.5%（P=0.129），无进展生存率（PFS）分别为 90.0%和 53.8%（P=0.074）。IMRT+Endostar 组口干症 0、1、2 级发生率分别为 70.0%、20.0%、10.0%，IMRT+CCT 组分别为 15.4%、76.9%、7.7%，两组差异有统计学意义（P=0.020）。IMRT+Endostar 组张口困难 0、1、2 级发生率分别为 100.0%、0%、0%，IMRT+CCT 组分别为 53.8%、38.5%、7.7%，两组差异有统计学意义（P=0.044）。IMRT+Endostar 组颈面部软组织纤维化 0、1、2 级发生率分别为 40.0%、60.0%、0%，IMRT+CCT 组分别为 0%、76.9%、23.1%，两组差异有统计学意义（P=0.027）。
局部晚期 NPC 患者 IMRT+Endostar 组与 IMRT+CCT 组的长期疗效差异无统计学意义，但 IMRT+Endostar 组疗效较好，晚期不良反应较轻。需要进一步开展样本量更大、随访时间更长的研究。
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