全程IMRT和西妥昔单抗、同期顺铂化疗治疗44例局部晚期口咽癌的效果对比
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摘要
目的对比全程IMRT和西妥昔单抗、同期顺铂化疗治疗44例局部晚期口咽癌的效果。方法随机选取2013年8月—2015年8月该院局部晚期口咽癌患者44例,按先后序列号(1～44)随机分为两组:一组全程IMRT和西妥昔单抗、同期顺铂化疗治疗组(研究组,22例),一组全程IMRT和西妥昔单抗治疗组(对照组,22例),统计分析两组患者的临床疗效、3年LCR、PFS、OS、不良反应发生情况。结果研究组患者的3年LCR、PFS、OS 90.9%(20/22)、77.3%(17/22)、86.4%(19/22)均显著高于对照组77.3%(17/22)、59.1%(13/22)、68.2%(15/22)(χ~2=11.14、12.83、13.34,P<0.05)。研究组患者的0～1级痤疮/痒/皮疹发生,100.0%(22/22)显著高于对照组50.0%(11/22)(χ~2=11.34,P<0.05),2级、3级痤疮/痒/皮疹发生率0、0均显著低于对照组27.3%(6/22)、22.7%(5/22)(χ~2=13.28,14.45,P<0.05);0～1级血液学毒性发生率59.1%(13/22)显著低于对照组86.4%(19/22)(χ~2=6.63,P<0.05),2级、3级血液学毒性发生率22.7%(5/22)、18.2%(4/22)均显著高于对照组9.1%(2/22)、4.5%(1/22)(χ~2=9.21、11.01,P<0.05)。结论全程IMRT和西妥昔单抗、同期顺铂化疗治疗局部晚期口咽癌的疗效与全程IMRT和西妥昔单抗治疗相当,更能有效提升患者的3年LCR、PFS、OS,降低患者的痤疮/痒/皮疹发生率,但会提升患者的血液学毒性发生率。
Objective To compare the efficacy of whole course IMRT, cetuximab and cisplatin in the treatment of 44 patients with locally advanced oropharyngeal cancer. Methods A total of 44 cases of patients with locally advanced oropharyngeal cancer in our hospital from August 2013 to August 2015 were randomly selected and divided into two groups according to serial number(1-44). One group were treated with IMRT and cetuximab, cisplatin chemotherapy(study group, 22 cases), and the other group were treated with IMRT and cetuximab(control group, 22 cases). The clinical efficacy, 3-year LCR, PFS, OS and adverse reactions of the two groups were statistically analyzed. Results The LCR, PFS, OS of the study group were 90.9%(20/22), 77.3%(17/22) and 86.4%(19/22), which were significantly higher than those in the control group 77.3%(17/22), 59.1%(13/22) and 68.2%(15/22)(χ~2=11.14, 12.83, 13.34, P<0.05). The incidence of acne/itch/rash of the study group 100.0%(22/22) was significantly higher than the control group 50.0%(11/22)(χ~2=11.34, P<0.05). The incidence of acne/itch/rash in grade 2 and grade 3 of the study group were significantly lower than the control group 27.3%(6/22), 22.7%(5/22)(χ~2=13.28, 14.45, P<0.05). And the incidence of hematological toxicity in grade 0～1(13/22) 53.1% was significantly lower than the control group 86.4%(19/22)(χ~2=6.63, P<0.05). The incidence of grade 2 and grade 3 hematological toxicity 22.7%(5/22) and 18.2%(4/22) were significantly higher than the control group 9.1%(2/22) and 4.5%(1/22)(χ~2=9.21, 11.01, P<0.05). Conclusion The efficacy of whole course IMRT, cetuximab and cisplatin in the treatment of locally advanced oropharyngeal cancer is comparable to whole course IMRT and cetuximab, which can more effectively improve the 3-year LCR, PFS and OS of patients, reduce the incidence of acne/itch/rash, but will increase the incidence of hematological toxicity.
Objective To compare the efficacy of whole course IMRT, cetuximab and cisplatin in the treatment of 44 patients with locally advanced oropharyngeal cancer. Methods A total of 44 cases of patients with locally advanced oropharyngeal cancer in our hospital from August 2013 to August 2015 were randomly selected and divided into two groups according to serial number(1-44). One group were treated with IMRT and cetuximab, cisplatin chemotherapy(study group, 22 cases), and the other group were treated with IMRT and cetuximab(control group, 22 cases). The clinical efficacy, 3-year LCR, PFS, OS and adverse reactions of the two groups were statistically analyzed. Results The LCR, PFS, OS of the study group were 90.9%(20/22), 77.3%(17/22) and 86.4%(19/22), which were significantly higher than those in the control group 77.3%(17/22), 59.1%(13/22) and 68.2%(15/22)(χ~2=11.14, 12.83, 13.34, P<0.05). The incidence of acne/itch/rash of the study group 100.0%(22/22) was significantly higher than the control group 50.0%(11/22)(χ~2=11.34, P<0.05). The incidence of acne/itch/rash in grade 2 and grade 3 of the study group were significantly lower than the control group 27.3%(6/22), 22.7%(5/22)(χ~2=13.28, 14.45, P<0.05). And the incidence of hematological toxicity in grade 0～1(13/22) 53.1% was significantly lower than the control group 86.4%(19/22)(χ~2=6.63, P<0.05). The incidence of grade 2 and grade 3 hematological toxicity 22.7%(5/22) and 18.2%(4/22) were significantly higher than the control group 9.1%(2/22) and 4.5%(1/22)(χ~2=9.21, 11.01, P<0.05). Conclusion The efficacy of whole course IMRT, cetuximab and cisplatin in the treatment of locally advanced oropharyngeal cancer is comparable to whole course IMRT and cetuximab, which can more effectively improve the 3-year LCR, PFS and OS of patients, reduce the incidence of acne/itch/rash, but will increase the incidence of hematological toxicity.
引文
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[2]万山,金风,吴伟莉,等.两种不同给药速度的时辰化疗联合调强放疗治疗局部晚期鼻咽癌的临床研究[J].中华放射医学与防护杂志,2018,38(4):278-284.
[3]姜琳,楼建林,王可敬,等.计划性颈淋巴清扫术在局部晚期头颈部鳞状细胞癌综合治疗中的应用[J].中华耳鼻咽喉头颈外科杂志,2018,53(2):92-96.
[4]周明镇,余元祥,伍方才,等.调强放疗同期联合5-FU+顺铂或奥沙利铂治疗局部晚期鼻咽癌的效果比较[J].广东医学,2017,38(2):308-311.
[5]白静,宋琦,黄则雷,等.诱导化疗联合同步放化疗对局部晚期头颈鳞状细胞癌疗效和安全性的Meta分析[J].中国耳鼻咽喉头颈外科,2017,24(11):575-581.
[6]徐莹,任雪,阎英,等.放化疗联合尼妥珠单抗治疗局部晚期鼻咽癌临床疗效观察[J].临床军医杂志,2018,46(3):267-271.
[7]郝金国,刘长琦.28例口咽癌扩大根治术的麻醉处理[J].中外医疗,2014,33(21):114,116.
[8]张鹏.MRI在鼻咽癌诊断中的应用价值探析[J].中外医疗,2012,31(4):182.