CAJ | 학술논문

目的观察尼妥珠单抗联合同步放化疗治疗局部晚期鼻咽癌的安全性和有效性。方法40例Ⅲ～Ⅳa期初治鼻咽部未分化非角化性癌患者，按就诊单双号分为两组，每组20例。治疗组采用尼妥珠单抗静脉滴注，100 mg·次-1·周-1，连用6～8周；适形调强放疗并同步卡铂＋5-氟尿嘧啶（ CF）方案化疗2～6周期。对照组采用适形调强放疗同步CF方案化疗，方法同治疗组。采用免疫组化方法检测患者肿瘤组织表皮生长因子受体（ EGFR）、原位杂交法检测表皮主长因子受体（ EBER）的表达，治疗结束3、6、12个月评价两组的疗效和安全性。结果治疗组和对照组的癌组织表达阳性EGFR 率分别为90．0％、100．0％；两组癌组织EBER阳性表达率均为100．0％。 EGFR、EBER在两组的表达差异无统计学意义（ P＞0．05）；治疗后3、6个月治疗组疗效均优于对照组（P＜0．05）；治疗期间两组不良反应严重程度比较，差异均无统计学意义（P＞0．05）。结论鼻咽部未分化非角化性癌EGFR阳性表达率高，尼妥珠单抗联合同步放化疗治疗局部晚期鼻咽癌提高了疗效，且未加重同步放化疗的不良反应，患者耐受性好。
목적관찰니타주단항연합동보방화료치료국부만기비인암적안전성화유효성。방법40례Ⅲ～Ⅳa기초치비인부미분화비각화성암환자，안취진단쌍호분위량조，매조20례。치료조채용니타주단항정맥적주，100 mg·차-1·주-1，련용6～8주；괄형조강방료병동보잡박＋5-불뇨밀정（ CF）방안화료2～6주기。대조조채용괄형조강방료동보CF방안화료，방법동치료조。채용면역조화방법검측환자종류조직표피생장인자수체（ EGFR）、원위잡교법검측표피주장인자수체（ EBER）적표체，치료결속3、6、12개월평개량조적료효화안전성。결과치료조화대조조적암조직표체양성EGFR 솔분별위90．0％、100．0％；량조암조직EBER양성표체솔균위100．0％。 EGFR、EBER재량조적표체차이무통계학의의（ P＞0．05）；치료후3、6개월치료조료효균우우대조조（P＜0．05）；치료기간량조불량반응엄중정도비교，차이균무통계학의의（P＞0．05）。결론비인부미분화비각화성암EGFR양성표체솔고，니타주단항연합동보방화료치료국부만기비인암제고료료효，차미가중동보방화료적불량반응，환자내수성호。
Objective To investigate the safety and efficacy of nimotuzumab combined with concurrent che-moradiotherapy for locally advanced nasopharyngeal carcinoma .Methods Forty untreated cases of III-Ⅳa stage naso-pharyngeal undifferentiated non-keratinizing carcinoma were divided into two groups according to their first visit date , 20 cases in each group.The treatment group was given nimotuzumab (intravenous infusion of 100mg once a week),and the treatment lasted for 6-8 weeks;Conformal intensity modulated radiotherapy combined with concurrent CF chemo-therapy was performed in the treatment group for 2 to 6 cycles.Conformal intensity modulated radiotherapy combined with CF chemotherapy was performed in the control group ,the same as in the treatment group .Immunohistochemistry was used to detect epidermal growth factor receptor ( EGFR) in tumor tissues while in situ hybridization assay was used to detect EBER expression .The safety and efficacy of treatment were evaluated 3,6 and 12 months after treatment,re-spectively.Results The positive rates of EGFR expression in the treatment group and control group were 90.0%and 100.0%,respectively.The positive rate of EBER expression was 100.0%in the two groups.There was no significant difference in the positive rates of EGFR and EBER expression between two groups (P>0.05).The efficacy of treat-ment for treatment group was superior to that for control group 3 months after treatment as well as 6 months after treat-ment( P<0.05 );There was no significant difference in the severity of adverse reaction between two groups during treatment period (P>0.05).Conclusion The positive rate of EGFR expression in the nasopharyngeal undifferentiat-ed non-keratinizing carcinoma is high .Nimotuzumab combined with concurrent chemoradiotherapy for locally advanced nasopharyngeal carcinoma can improve the efficacy ,its adverse reactions are similar with those of concurrent chemora-diotherapy ,and patient tolerance is good .