尼妥珠单抗联合调强放疗与吡柔比星化疗对EGFR阳性晚期鼻咽癌的疗效分析  

Therapeutic Effect of Nimotuzumab Combined with Intensity-modulated Radiotherapy and Pirarubicin Chemotherapy on EGFR-positive Advanced Nasopharyngeal Carcinoma

作　　者：于剑飞 崔慧林[2] 王宏卫[3] YU Jianfei;CUI Huilin;WANG Hongwei(Shanxi Medical University,Taiyuan,030001)

机构地区：[1]山西医科大学基础医学院,030001 [2]山西医科大学基础医学院组胚教研室,030001 [3]山西省肿瘤医院,030013

出　　处：《实用癌症杂志》2020年第4期566-569,共4页The Practical Journal of Cancer

摘　　要：目的探究尼妥珠单抗联合调强放疗与吡柔比星化疗对表皮生长因子受体(EGFR)阳性晚期鼻咽癌的治疗效果。方法选取经病理学确诊的88例EGFR阳性晚期鼻咽癌,随机数表法将患者分为观察组与对照组,各44例。对照组给予调强放疗与吡柔比星化疗的同步放化疗治疗;观察组在对照组的基础上给予尼妥珠单抗治疗。比较两组患者治疗前、后的卡氏(Karnofsky,KPS)评分、治疗期间死亡率、复发率、毒副作用发生率等。对患者进行30个月的随访,统计随访期间的死亡人数及时间。结果两组治疗前KPS评分的差异无统计学意义(P>0.05)。治疗后对照组与观察组的KPS评分分别为(62.48±11.54)分与(74.20±12.43)分,差异具有统计学意义(t=-4.823,P=0.003);相比于对照组,观察组患者的复发率显著降低(χ^2=5.091,P=0.024),而两组治疗期间死亡率差异无统计学意义(χ^2=0.345,P=0.557)。对照组与观察组患者毒副作用的发生率均无显著差异(P>0.05)。相比于对照组,观察组患者的生存率显著提高,差异具有统计学意义(χ^2=6.224,P=0.013)。Cox分析结果提示,应用尼妥珠单抗是降低患者死亡风险的重要因素(RR=0.333,95%CI:0.165~0.672,P=0.002)。结论尼妥珠单抗联合调强放疗与吡柔比星化疗对晚期EGFR阳性鼻咽癌具有一定疗效,在临床上具有推广使用价值。Objective To investigate the effect of nitolimumab combined with intensity-modulated radiotherapy and pirarubicin chemotherapy on epidermal growth factor receptor(EGFR)-positive advanced nasopharyngeal carcinoma.Methods 88 cases of EGFR-positive advanced nasopharyngeal carcinoma diagnosed by pathology were selected,and the patients were divided into observation group and control group by random number table method,44 cases each.The control group received concurrent chemoradiotherapy with intensity-modulated radiotherapy and pirarubicin chemotherapy,and the observation group received nimotuzumab on the basis of the control group.The karnofsky(KPS)scores before and after treatment,and the mortality rate,recurrence rate and the incidence of side effects were compared between the two groups.Patients were followed up for 30 months to count the number of deaths and time during the follow-up period.Results There was no significant difference in KPS scores between the two groups before treatment(P>0.05).After treatment,the KPS scores of the control group and the observation group were(62.48±11.54)and(74.20±12.43),respectively,and the difference was statistically significant(t=-4.823,P=0.003).Compared with the control group,the recurrence rate of the observation group was significantly lower(χ^2=5.091,P=0.024),but there was no significant difference in mortality between the 2 groups(χ^2=0.345,P=0.557).There was no significant difference in the incidence of side effects between the control group and the observation group(P>0.05).Compared with the control group,the survival rate of the observation group was significantly increased,and the difference was statistically significant(χ^2=6.224,P=0.013).Cox analysis suggested that the use of nimotuzumab was an important factor in reducing the risk of death in patients(RR=0.333,95%CI:0.165~0.672,P=0.002).Conclusion Nimotuzumab combined with intensity-modulated radiotherapy and pirarubicin chemotherapy have a certain effect on advanced EGFR-positive nasopharyngeal carcinoma,an

关 键 词：尼妥珠单抗 鼻咽癌 表皮生长因子受体 化疗 放疗 

分 类 号：R739.62[医药卫生—肿瘤]