尼妥珠单抗联合调强放疗及 GP 方案治疗局部复发鼻咽癌的临床观察

【目的】探讨尼妥珠单抗联合调强放疗及吉西他滨加顺铂（GP）方案治疗局部复发鼻咽癌的疗效。【方法】将本院71例局部复发鼻咽癌患者随机分为观察组（35例）和对照组（36例），两组均采用调强放疗和吉西他滨加顺铂方案化疗，观察组每周一次放疗前静脉滴注尼妥珠单抗100 mg，共6～7次。观察比较两组患者治疗疗效。【结果】观察组治疗结束3个月后原发灶完全缓解率及治疗1年及2年后局部控制率分别为65．7％、91．4％及82．9％，而对照组为41．7％、72．2％及61．1％，两组相比较差异有显著性（P＜0．05）。观察组治疗后1年及2年无远处转移生存率分别为88．6％及77．1％，而对照组为75．0％及66．6％，观察组要高于对照组，但两组相比较差异无显著性（P＞0．05）。两组的近期及远期不良反应发生率无统计学差异（P ＞0．05）。【结论】尼妥珠单抗联合调强放疗及 GP方案能提高局部复发鼻咽癌的完全缓解率及局部控制率。

Clinical Observation of Nimotuzumab Combined with IMRT and GP Regimen in the Treatment of Locally Recurrent Nasopharyngeal Carcinoma

Obj ective]To explore the efficacy of nimotuzumab combined with intensity-modulated radiothera-py（IMRT）and GP regimen（gemcitabine plus cisplatin）in the treatment of locally recurrent nasopharyngeal carci-noma（NPC）.Methods]A total of 7 1 patients with locally recurrent NPC in our hospital were randomly divided into observation group（n=35）and control group（n=36）.All patients received IMRT and GP regimen（gemcit-abine plus cisplatin）.The observation group was intravenously administered nimotuzumab 100mg weekly for 6～7 weeks before radiotherapy.The efficacy of two groups was observed and compared.Results]The complete re-sponse（CR）of primary lesion at 3 months after treatment and local control rate at 1 and 2 years after treatment in the observation group were 65.7%,91.4% and 82.9% respectively,while those in the control group were 41.7%,72.2% and 61.1% respectively,and there was significant difference between two groups（P 〈0.05）. The distant metastasis-free survival rate in the observation group at 1 and 2 years after treatment were 88.6% and 77.1% respectively which were higher than those in the control group（75.0% and 66.6%,respectively）,but there was no significant difference between two groups（P〉0.05）.There was no significant difference in the inci-dence of short-term and long-term toxic side effects between two groups.Conclusion]Nimotuzumab combined with IMRT and GP regimen can improve the CR rate and local control rate of locally recurrent NPC.