CAJ | 학술논문

目的探讨三维适形放疗(3D-CRT)联合尼妥珠单抗及紫杉醇顺铂化疗方案治疗Ⅲ、ⅣA期鼻咽癌的疗效及毒副作用.方法经组织病理确诊的Ⅲ、ⅣA期(2008分期)鼻咽癌初诊患者60例.采取3D-CRT及同期和序贯紫杉酵顺铂方案化疗,每周一放疗前行尼妥珠单抗100 mg治疗,共6～7次.观察2个月后原发灶CR率、颈部淋巴结CR率、治疗后1、2、3年局部控制率及无远处转移率及不良反应情况.结果放疗后2个月原发灶CR率为98.3％、颈部淋巴结CR率96.7％.治疗后1年局部控制率为100％、无远处转移率为96.7％；2、3年后局部控制率、无远处转移生存率均为100.0％.主要不良反应为放射性咽喉炎、放射性皮炎和恶心呕吐、白细胞减少、疲乏等.结论尼妥珠单抗联合3D-CRT及紫杉醇及顺铂同期及序贯化疗治疗局部晚期鼻咽癌完全缓解率及局部控制率、无远处转移生存率提高,耐受性好.
목적 탐토삼유괄형방료(3D-CRT)연합니타주단항급자삼순순박화료방안치료Ⅲ、ⅣA기비인암적료효급독부작용.방법 경조직병리학진적Ⅲ、ⅣA기(2008분기)비인암초진환자60례.채취3D-CRT급동기화서관자삼효순박방안화료,매주일방료전행니타주단항100 mg치료,공6～7차.관찰2개월후원발조CR솔、경부림파결CR솔、치료후1、2、3년국부공제솔급무원처전이솔급불량반응정황.결과 방료후2개월원발조CR솔위98.3％、경부림파결CR솔96.7％.치료후1년국부공제솔위100％、무원처전이솔위96.7％；2、3년후국부공제솔、무원처전이생존솔균위100.0％.주요불량반응위방사성인후염、방사성피염화악심구토、백세포감소、피핍등.결론 니타주단항연합3D-CRT급자삼순급순박동기급서관화료치료국부만기비인암완전완해솔급국부공제솔、무원처전이생존솔제고,내수성호.
Objective To explore the effect and safety of three-dimensional conformal radiotherapy (3D-CRT) m combination with nimotuzumab and chemotherapy in treatment patients with locoregionally advanced nasopharyngeal carcinoma.Methods 60 patients with stages Ⅲ-ⅣA nasopharyngeal carcinoma were enrolled.All patients were treated with 3D-CRT and concurrent and sequential chemotherapy by paclitaxel and eisplatin and given nimotuzumab 100mg i.v.weekly for 6 ～ 7 weeks before radiotherapy.Results After two months,the complete response rates(CR) of nasopharyngeal carcinoma and cervix lymph nodes were 98.3％,96.7％ respectively,l-year locoregional control and distant metastasis-free survival rates were 100％,96.7％ in 38 patients.2-year,3-year locoregional control and distant metastasis-free survival rates were 100％ in 16 patients and 8 patients.The major side effects included oral mucositis,actinodermatitis,neutropenia,nausea,vomiting,and fatigue.Grade 3 acute oral mucositis often occured.No skin rash or allergic toxicities appeared.All the effects were tolerable.Conclusion 3D-CRT combined with nimotuzumab and peclitaxel and cisplatin chemotherapy may improve the complete response rate and locoregional control and distant metastasis-free survival rate on locoregionally advanced nasopharyngeal carcinoma,with mild to moderate side effects.