全程超分割调强放疗同步化疗和尼妥珠单抗治疗中晚期鼻咽癌的临床研究  

Clinical study of simultaneous whole-course hyperfractionated intensity-modulated radiation therapy combined with chemotherapy and nimotuzumab in treatment of advanced nasopharyngeal carcinoma

作　　者：周素珠[1] 陈璐 汤亚莉[1] 何嘉文 丁春江[2] Zhou Suzhu;Chen Lu;Tang Yali;He Jiawen;Ding Chunjiang(Tumor Zone 1,Kaiping Central Hospital of Guangdong Province,Kaiping 529100,China;Radiotherapy Center,Kaiping Central Hospital of Guangdong Province,Kaiping 529100,China)

机构地区：[1]广东省开平市中心医院肿瘤一区,529100 [2]广东省开平市中心医院放疗中心,529100

出　　处：《肿瘤研究与临床》2021年第4期287-291,共5页Cancer Research and Clinic

摘　　要：目的探讨全程超分割调强放疗同步化疗和尼妥珠单抗治疗中晚期鼻咽癌的临床效果。方法选取广东省开平市中心医院2017年6月至2019年1月收治的64例中晚期鼻咽癌患者,按随机数字表法分为观察组和对照组,每组32例。两组均在放疗基础上同步化疗和尼妥珠单抗治疗,观察组行全程超分割调强放疗,对照组行常规分割调强放疗。观察两组患者近期疗效、Karnofsky评分、总生存率、无进展生存率、急性放射反应及晚期放射损伤情况。结果放疗后6个月,观察组有效率高于对照组[96.9%(31/32)比75.0%(24/32),χ^(2)=6.335,P<0.05]。放疗结束时及放疗结束3个月时,观察组Karnofsky评分均高于对照组,差异均有统计学意义[(75±3)分比(71±3)分,t=5.891,P<0.05;(80±4)分比(77±4)分,t=3.201,P=0.002]。全组患者耐受性良好,未见4级急性放射反应,均按计划完成放疗。观察组口腔黏膜反应发生率低于对照组[21.9%(7/32)比50.0%(16/32),χ^(2)=5.497,P<0.05]。观察组重度口干、颈部软组织纤维化发生率均低于对照组[6.2%(2/32)比28.1%(9/32),χ^(2)=5.379,P=0.043;3.1%(1/32)比21.9%(7/32),χ^(2)=5.143,P<0.05]。随访时间14~20个月,中位随访时间17个月。两组总生存时间差异无统计学意义(χ^(2)=0.553,P=0.557),观察组无进展生存时间优于对照组(χ^(2)=3.954,P=0.044)。结论全程超分割调强放疗同步化疗和尼妥珠单抗治疗中晚期鼻咽癌疗效确切,不良反应可耐受。Objective To explore the clinical effect of simultaneous whole-course hyperfractionated intensity-modulated radiation therapy combined with chemotherapy and nimotuzumab in the treatment of advanced nasopharyngeal carcinoma.Methods A total of 64 patients with advanced nasopharyngeal carcinoma who were admitted to Kaiping Central Hospital of Guangdong Province from June 2017 to January 2019 were selected and divided into the observation group and control group according to the random number table method,with 32 cases in each group.Both groups were given chemotherapy and nimotuzumab on the basis of radiotherapy.The observation group received simultaneous whole-course hyperfractionated intensity-modulated radiation therapy,and the control group received conventional fractionated intensity-modulated radiation therapy.The short-term efficacy,Karnofsky score,overall survival rate,progression-free survival rate,acute radiation reaction,and late radiation injury in the two groups were observed.Results Six months after radiotherapy,the efficient rate of the observation group was higher than that of the control group[96.9%(31/32)vs.75.0%(24/32),χ^(2)=6.335,P<0.05].At the end of radiotherapy and 3 months after the end of radiotherapy,the Karnofsky scores of the observation group were higher than those of the control group,and the differences were statistically significant[(75±3)points vs.(71±3)points,t=5.891,P<0.05;(80±4)points vs.(77±4)points,t=3.201,P=0.002].All patients were well tolerated,no grade 4 acute radiation reaction was observed,and radiotherapy was completed as planned.The incidence rate of oral mucosal reaction in the observation group was lower than that in the control group[21.9%(7/32)vs.50.0%(16/32),χ^(2)=5.497,P<0.05].The incidence rates of severe dry mouth and neck soft tissue fibrosis in the observation group were lower than those in the control group[6.2%(2/32)vs.28.1%(9/32),χ^(2)=5.379,P=0.043;3.1%(1/32)vs.21.9%(7/32),χ^(2)=5.143,P<0.05].The follow-up time was 14-20 months,and the median follow-

关 键 词：鼻咽肿瘤 放射疗法 计算机辅助 抗肿瘤联合化疗方案 

分 类 号：R739.63[医药卫生—肿瘤]