中华放射肿瘤学杂志
中華放射腫瘤學雜誌
중화방사종류학잡지
CHINESE JOURNAL OF RADIATION ONCOLOGY
2012年
3期
201-204
,共4页
陈春燕%赵充%高黎%郎锦义%潘建基%胡超苏%金风%王仁生%谢丛华%林桐榆%卢泰祥
陳春燕%趙充%高黎%郎錦義%潘建基%鬍超囌%金風%王仁生%謝叢華%林桐榆%盧泰祥
진춘연%조충%고려%랑금의%반건기%호초소%금풍%왕인생%사총화%림동유%로태상
鼻咽肿瘤/放射疗法%化学疗法%靶向治疗%不良反应
鼻嚥腫瘤/放射療法%化學療法%靶嚮治療%不良反應
비인종류/방사요법%화학요법%파향치료%불량반응
Nasopharyngeal neoplasms/radiotherapy%Chemotherapy%Target therapy%Adverse event
目的 通过开放性、多中心临床研究探讨西妥昔单抗联合同期顺铂化疗加调强放疗(IMRT)局部晚期鼻咽癌的安全性.方法 100例Ⅲ～Ⅳb期初治鼻咽癌患者入组,IMRT处方剂量鼻咽原发灶66.0～75.9Gy,颈部阳性淋巴结60～70 Gy;同期顺铂化疗剂量80mg/m2(每3周)；西妥昔单抗首剂400 mg/m2(放疗前,第1周),其后250 mg/m2(每周).按不良反应常见术语标准3.0版评价这一联合方案的不良反应.结果 全组患者治疗依从性良好.鼻咽原发灶大体肿瘤体积实际中位剂量为69.96 Gy,颈部阳性淋巴结大体肿瘤体积为68 Gy.同期顺铂中位剂量为133mg/疗程；西妥昔单抗中位起始剂量为690 mg,中位维持剂量为410mg/周.治疗期间主要不良反应为痤疮样皮疹、口腔黏膜炎以及放射性皮炎,其中1级放射性皮炎及＞2级口腔黏膜炎分别占58％、90％,2％患者出现4级口腔黏膜炎.骨髓抑制较为轻微,仅分别有8％、4％和5％患者出现＞2级中性粒细胞减少、血小板降低和贫血.结论 西妥昔单抗联合同期顺铂化疗加调强放疗局部晚期鼻咽癌的患者依从性好,不良反应可耐受.
目的 通過開放性、多中心臨床研究探討西妥昔單抗聯閤同期順鉑化療加調彊放療(IMRT)跼部晚期鼻嚥癌的安全性.方法 100例Ⅲ～Ⅳb期初治鼻嚥癌患者入組,IMRT處方劑量鼻嚥原髮竈66.0～75.9Gy,頸部暘性淋巴結60～70 Gy;同期順鉑化療劑量80mg/m2(每3週)；西妥昔單抗首劑400 mg/m2(放療前,第1週),其後250 mg/m2(每週).按不良反應常見術語標準3.0版評價這一聯閤方案的不良反應.結果 全組患者治療依從性良好.鼻嚥原髮竈大體腫瘤體積實際中位劑量為69.96 Gy,頸部暘性淋巴結大體腫瘤體積為68 Gy.同期順鉑中位劑量為133mg/療程；西妥昔單抗中位起始劑量為690 mg,中位維持劑量為410mg/週.治療期間主要不良反應為痤瘡樣皮疹、口腔黏膜炎以及放射性皮炎,其中1級放射性皮炎及＞2級口腔黏膜炎分彆佔58％、90％,2％患者齣現4級口腔黏膜炎.骨髓抑製較為輕微,僅分彆有8％、4％和5％患者齣現＞2級中性粒細胞減少、血小闆降低和貧血.結論 西妥昔單抗聯閤同期順鉑化療加調彊放療跼部晚期鼻嚥癌的患者依從性好,不良反應可耐受.
목적 통과개방성、다중심림상연구탐토서타석단항연합동기순박화료가조강방료(IMRT)국부만기비인암적안전성.방법 100례Ⅲ～Ⅳb기초치비인암환자입조,IMRT처방제량비인원발조66.0～75.9Gy,경부양성림파결60～70 Gy;동기순박화료제량80mg/m2(매3주)；서타석단항수제400 mg/m2(방료전,제1주),기후250 mg/m2(매주).안불량반응상견술어표준3.0판평개저일연합방안적불량반응.결과 전조환자치료의종성량호.비인원발조대체종류체적실제중위제량위69.96 Gy,경부양성림파결대체종류체적위68 Gy.동기순박중위제량위133mg/료정；서타석단항중위기시제량위690 mg,중위유지제량위410mg/주.치료기간주요불량반응위좌창양피진、구강점막염이급방사성피염,기중1급방사성피염급＞2급구강점막염분별점58％、90％,2％환자출현4급구강점막염.골수억제교위경미,부분별유8％、4％화5％환자출현＞2급중성립세포감소、혈소판강저화빈혈.결론 서타석단항연합동기순박화료가조강방료국부만기비인암적환자의종성호,불량반응가내수.
Objective To evaluate the safety of cetuximab combined with intensity-modulated radiotherapy (IMRT) plus concurrent cisplatin chemotherapy in locoregionally advanced nasopharyngeal carcinoma (NPC) in a Chinese multicenter clinical study.Methods From July 2008 to April 2009,100Patients with primary stage Ⅲ- Ⅳb non-keratinizing NPC were enrolled.The planned dose of IMRT to gross tumor volume and positive cervical lymph nodes was 66.0-75.9 Gy and 60-70 Gy in 30-33 fractions.Cisplatin (80 mg/m2,q3 week (w)) and cetuximab (400 mg/m2 one w before radiation,and then 250mg/m2 per w) were given concurrently.The adverse events (AEs) were graded according to common terminology criteria for adverse events v3.0.Results The compliance of the entire group of patient was satisfactory.Actual median dose to gross tumor volume was 69.96 Gy,and the median dose to positive cervical lymph nodes was 68 Gy.Median dose of cisplatin was 133 mg,median first-dose of cetuximab was 690 mg,and median weekly dose was 410 mg.AEs were well tolerated and manageable,mainly consisting of acneiform skin eruptions,dermatitis and mucositis.Grade 4 mucositis was observed in 2％ of the patients and no other grade 4 AEs were observed.Conclusions The combined treatment modality of IMRT +concurrent chemotherapy + cetuximab in loco-regionally advanced NPC is well tolerated.
