三维适形调强放疗同步顺铂化疗联合尼妥珠单抗治疗局部晚期鼻咽癌的临床疗效  

Clinical observation of locally advanced nasopharyngeal carcinoma treated by threedimensional conformal radiation therapy(3DCRT)/intensity-modulated radiation therapy(IMRT)and synchronous cisplatin chemotherapy combined with Nimotuzumab

作　　者：吴金通[1] 彭俊英[1] 吴陈宾 沈芬[1] 

机构地区：[1]南京军区福州总医院第一附属医院放疗科,福建莆田351100

出　　处：《中国癌症防治杂志》2014年第1期47-51,共5页CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT

摘　　要：目的 观察三维适形调强放疗同步顺铂化疗联合分子靶向药物尼妥珠单抗治疗局部晚期鼻咽癌患者的临床疗效、耐受性及安全性。方法 选取本院收治的初治局部晚期鼻咽癌患者40例，采用三维适形调强放疗同步顺铂化疗联合分子靶向药物尼妥珠单抗治疗。三维适形调强放疗靶区剂量PGTVnx及PGTVnd均为69.96~73.92 Gy、PTV-1为60~66 Gy、PTV-2为54~56 Gy，共分割33次。化疗方案：顺铂80 mg/m2，静滴，3周为1个周期，每个周期的首日使用，共2个周期；放疗的第1天给予尼妥珠单抗（泰欣生）100 mg，每周1次，共8周。随访观察患者治疗的临床疗效、耐受性及安全性。结果 40例患者均按计划完成治疗，所有患者至少随访24个月，随访率100%，在随访期内1例局部进展。治疗后6个月评价，鼻咽病灶和淋巴结的有效率均为97.5%。治疗期间发生Ⅲ级骨髓抑制9例，Ⅲ级口腔黏膜炎8例，无Ⅳ级毒副反应发生。结论 三维适形调强放疗同步顺铂化疗联合分子靶向药物尼妥珠单抗治疗局部晚期鼻咽癌的近期疗效显著，耐受性及安全性良好，值得临床推广应用。Objective To investigate the clinical efficacy,tolerability and safety of three-dimensional conformal radiation therapy （3DCRT）/intensity-modulated radiation therapy（IMRT）and synchronous cisplatin chemotherapy combined with nimotuzumab for previously untreated,locally advanced nasopharyngeal carcinoma. Methods 40 patients with untreated,locally advanced nasopha-ryngeal carcinoma were enrolled.All patients received 3DCRT/IMRT and synchronous cisplatin chemotherapy combined with nimo-tuzumab.Planned IMRT doses in the target region were 69.96-73.92 Gy for PGTVnx,69.96-73.92 Gy for PGTVnd,60-66 Gy for PTV-1 and 54-56 Gy for PTV-2 in 33 fractions.Cisplatin（80 mg/m2 on the first day of each cycle,once every 3 weeks for a total of 2 cycles）was given concurrently with Nimotuzumab（100 mg on day 1 of radiotherapy,then once a week for a total of 8 times）. Clinical efficacy,tolerability and safety were analyzed during follow-up. Results All 40 patients completed the treatment as planned,and all patients were followed up at least 24 months. Only one patient suffered local recurrence during follow-up.At 6 months after treatment,response rate（RR） in terms of both primary lesions and positive lymph nodes was 97.5%. Acute side effects during treatment included 9 cases of grade 3 bone marrow suppression and 8 cases of grade 3 oral mucositis.No grade 4 toxicity occurred. Conclusion 3DCRT/IMRT and synchronous cisplatin chemotherapy combined with nimotuzumab showed good clinical efficacy,tolerability and safety,suggesting that the teatment can be recommended.

关 键 词：鼻咽肿瘤 三维适形调强放疗 同步化疗 分子靶向治疗 尼妥珠单抗 

分 类 号：R739.63[医药卫生—肿瘤]