CAJ | 학술논문

目的分析头颈部肿瘤EGFR单抗用后嗅觉障碍病例的临床特点,结合复习文献探讨EGFR单抗治疗的安全性及其致嗅觉丧失的可能机制.方法回顾分析2008-2012年在本科接受IMRT±同期化疗联合EGFR单抗治疗的头颈部肿瘤(鳞癌及鼻咽癌)患者328例资料,统计急性不良反应发生情况.结果于IMRT±同期化疗前1周接受首次EGFR单抗治疗后出现嗅觉丧失者2例(0.6％),均为初治中年男性患者.1例为尼妥珠单抗治疗出现嗅觉丧失后继续使用,治疗结束后半年随访时嗅觉仍未恢复;1例为西妥昔单抗治疗出现嗅觉丧失后停药13 d嗅觉部分恢复,但继续使用尼妥珠单抗治疗后无变化.考虑嗅觉丧失的发生与EGFR单抗使用有关,但机制不清.结论 EGFR单抗治疗临床实践中应足够重视其出现的无法解释的罕见的不良反应.
목적 분석두경부종류EGFR단항용후후각장애병례적림상특점,결합복습문헌탐토EGFR단항치료적안전성급기치후각상실적가능궤제.방법 회고분석2008-2012년재본과접수IMRT±동기화료연합EGFR단항치료적두경부종류(린암급비인암)환자328례자료,통계급성불량반응발생정황.결과 우IMRT±동기화료전1주접수수차EGFR단항치료후출현후각상실자2례(0.6％),균위초치중년남성환자.1례위니타주단항치료출현후각상실후계속사용,치료결속후반년수방시후각잉미회복;1례위서타석단항치료출현후각상실후정약13 d후각부분회복,단계속사용니타주단항치료후무변화.고필후각상실적발생여EGFR단항사용유관,단궤제불청.결론 EGFR단항치료림상실천중응족구중시기출현적무법해석적한견적불량반응.
Objective To analyze the clinical features of patients with head and neck cancer who develop anosmia after treatment with anti-epidermal growth factor receptor (EGFR) monoclonal antibodies,and to investigate the safety of anti-EGFR monoclonal antibodies and the possible mechanism by which they cause anosmia,given the literature reviewed.Methods A retrospective analysis was performed on the clinical data of 328 patients with head and neck cancer (squamous cell carcinoma and nasopharyngeal carcinoma),who were treated with anti-EGFR monoclonal antibodies plus intensity-modulated radiotherapy (IMRT) with/without concurrent chemotherapy in our institution from January 2008 to September 2012,and treatment-related acute toxicities were statistically analyzed.Results Two (0.6％) of the 328 patients developed anosmia after the first dose of anti-EGFR monoclonal antibody given one week before IMRT with/ without concurrent chemotherapy,and both were middle-aged male patients initially treated.The first patient still used cetuximab after developing anosmia and did not recover his olfaction at 0.5 year after treatment as shown by follow-up;for the other patient,treatment was suspended for 13 d after anosmia was developed in the treatment with cetuximab and then the olfaction was partially restored,but no improvement was seen after 3 months of treatment with nimotuzumab.Thus,we suggested that anti-EGFR monoclonal antibodies contributed to anosmia in the two patients,but the exact mechanism was unknown.Conclusions Sufficient attention should be paid to the unexplained rare toxicities in the treatment with anti-EGFR monoclonal antibodies.