尼妥珠单抗治疗局部晚期鼻咽癌的近期疗效及不良反应分析  

Analysis on short-term curative effect and adverse reactions of nimotuzumab in treatment of locally advanced nasopharyngeal carcinoma

作　　者：孙健达 胡丹[1] 冯会亭 林晶晶 陈意标[1] 张汉雄[1] 熊俊[1] SUN Jianda;HU Dan;FENG Huiting;LIN Jingjing;CHEN Yibiao;ZHANG Hanxiong;XIONG Jun(Department of Radiation, Meizhou People's Hospital, Guangdong, Meizhou 514031, China)

机构地区：[1]广东省梅州市人民医院放疗科,广东梅州514031

出　　处：《中国医药科学》2019年第8期54-57,共4页China Medicine And Pharmacy

摘　　要：目的探讨尼妥珠单抗联合放化疗治疗局部区域晚期鼻咽癌的的近期疗效及不良反应。方法选取2015年4月～2017年12月收治的Ⅲ～Ⅳa期鼻咽癌患者共44例。所有患者均接受调强适形放疗联合铂类为基础的同期或续贯化疗,放疗过程中予以尼妥珠单抗治疗,每次200mg,每周1次。结果放疗结束时,鼻咽病灶CR 79.5%,PR 18.2%,SD 2.3%;颈部淋巴结CR 83.3%,PR 16.7%。放疗过程中患者的治疗耐受性较好,出现的毒副反应较小,主要的不良反应为血液学毒性、口腔黏膜炎、放射性皮肤反应、食欲减退及恶心/呕吐,大多为1/2级,仅有29.5%患者出现3/4级不良反应,无痤疮样皮疹、输液反应及治疗相关性死亡发生。结论尼妥珠单抗联合放化疗治疗局部区域晚期鼻咽癌的缓解率较高,近期疗效较好,出现的毒副反应较小。Objective To explore the short-term curative effect and adverse reactions of nimotuzumab combined with radiochemotherapy in treatment of locally advanced nasopharyngeal carcinoma. Methods 44 patients with stage III-IV a nasopharyngeal carcinoma who were admitted and treated in our hospital from April 2015 to December 2017 were selected. All patients were given intensity modulated radiotherapy (IMRT) combined with platinum-based concurrent or sequential chemotherapy. During radiotherapy, patients were treated with nimotuzumab once a week at a dose of 200mg. Results At the end of radiotherapy, CR, PR and SD of nasopharyngeal lesions were 79.5%, 18.2% and 2.3%, respectively. And CR and PR of cervical lymph nodes were 83.8% and 16.7%, respectively. During the period of radiotherapy, patients had better tolerance and fewer toxic side effects. The main adverse reactions were hematological toxicity, oral mucositis, radiative skin reaction, poor appetite, and nausea or vomiting. The majority of adverse reactions were grade 1 or 2, and only 13 (29.5%) patients had adverse reactions of grade 3 or 4. No acne-like rash, infusion reaction or treatment-related death occurred. Conclusion Nimotuzumab combined with radiochemotherapy in treatment of locally advanced nasopharyngeal carcinoma has higher remission rate and better short-term effect. Toxic side effects are fewer.

关 键 词：鼻咽肿瘤 放化疗 尼妥珠单抗 疗效 不良反应 

分 类 号：R739.63[医药卫生—肿瘤]