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放疗联合西妥昔单抗治疗顺铂不适用的肾功能不全局部晚期头颈部鳞状细胞癌:一项回顾性研究。

Radiotherapy plus cetuximab for locally advanced squamous cell head and neck cancer in patients with cisplatin-ineligible renal dysfunction: A retrospective study.

作者信息

Imai Chiaki, Saeki Hiromi, Yamamoto Kohei, Ichikawa Ayano, Arai Makoto, Tawada Akinobu, Suzuki Takaaki, Takiguchi Yuichi, Hanazawa Toyoyuki, Ishii Itsuko

机构信息

Division of Pharmacy, Chiba University Hospital, Chiba, Chiba 260-8677, Japan.

Department of Gastroenterology, Tokyo Women's Medical University, Yachiyo Medical Center, Yachiyo, Chiba 276-8524, Japan.

出版信息

Oncol Lett. 2022 May;23(5):152. doi: 10.3892/ol.2022.13271. Epub 2022 Mar 15.

Abstract

Clinical trials have not fully demonstrated the efficacy and safety of radiotherapy plus cetuximab for locally advanced squamous cell head and neck cancer (LA-SCCHN) in patients with cisplatin-ineligible renal dysfunction. Patients who received radiotherapy plus cetuximab for LA-SCCHN at Chiba University Hospital (Chiba, Japan) between July 2013 and October 2018 were retrospectively reviewed. Background characteristics and locoregional control and overall survival rates were compared between patients with and without renal dysfunction. Survival was examined using Kaplan-Meier analysis and an adjusted Cox proportional hazards model. Kaplan-Meier analysis demonstrated that overall survival was shorter in patients with creatinine clearance of <45 ml/min (P=0.041; log-rank test). However, there was no difference in the locoregional control rate (P=0.477; log-rank test). Adjusted Cox analysis revealed that the risk of death was increased by 2.52-fold (hazard ratio, 2.52; 95% confidence interval, 1.01-6.30; P=0.048) if creatinine clearance was <45 ml/min. Moderate to severe renal dysfunction did not affect the locoregional control rate in patients with LA-SCCHN treated with radiotherapy plus cetuximab but was an adverse prognostic factor.

摘要

对于肾功能不全而不符合顺铂治疗条件的局部晚期头颈部鳞状细胞癌(LA-SCCHN)患者,临床试验尚未充分证明放疗联合西妥昔单抗的疗效和安全性。回顾性分析了2013年7月至2018年10月期间在日本千叶大学医院接受放疗联合西妥昔单抗治疗LA-SCCHN的患者。比较了有无肾功能不全患者的背景特征、局部区域控制率和总生存率。采用Kaplan-Meier分析和调整后的Cox比例风险模型检查生存率。Kaplan-Meier分析表明,肌酐清除率<45 ml/min的患者总生存期较短(P=0.041;对数秩检验)。然而,局部区域控制率无差异(P=0.477;对数秩检验)。调整后的Cox分析显示,如果肌酐清除率<45 ml/min,死亡风险增加2.52倍(风险比,2.52;95%置信区间,1.01-6.30;P=0.048)。中度至重度肾功能不全对接受放疗联合西妥昔单抗治疗的LA-SCCHN患者的局部区域控制率没有影响,但却是一个不良预后因素。

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