三维适形调强放疗同步奈达铂化疗联合尼妥珠单抗靶向治疗鼻咽癌患者的疗效
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摘要
目的探讨三维适形调强放疗同步奈达铂化疗联合尼妥珠单抗靶向治疗鼻咽癌的临床疗效。方法选取2017年1月至2018年1月间广东医科大学附属医院收治的68例鼻咽癌患者,根据治疗方式不同分为观察组和对照组,每组34例。对照组患者采用三维适形调强放疗同步奈达铂化疗治疗,观察组患者在对照组基础上联合尼妥珠单抗靶向治疗,比较两组患者的临床疗效及不良反应发生情况。结果随访9个月后,观察组患者总有效率为79. 4%,高于对照组的55. 9%,差异有统计学意义(P <0. 05)。两组患者的不良反应发生情况比较,差异均无统计学意义(均P> 0. 05)。结论三维适形调强放疗同步奈达铂化疗联合尼妥珠单抗靶向治疗鼻咽癌患者的近期疗效、安全性及耐受性均良好,值得临床运用。
Objective To investigate the efficacy of targeted therapy of three-dimensional conformal intensity modulated radiotherapy(cisplatin or nedaplatin) combined with chemotherapy with nituzumab for nasopharyngeal carcinoma(NPC). Methods A total of 68 patients with nasopharyngeal carcinoma admitted to Affiliated Hospital of Guangdong Medical University from January 2017 to January 2018 were selected as the subjects. According to the treatment methods,the patients were divided into an observation group and a control group,with 34 patients in each group. The patients in the observation group were treated with nituzumab targeted therapy on the basis of the three-dimensional conformal intensity modulated radiotherapy and synchronized chemotherapy with platinum. The patients in the control group were treated with three-dimensional conformal intensity modulated radiotherapy(cisplatin or nedaplatin) and platinum-based chemotherapy. The curative efficacy and incidence of adverse reactions were compared between the two groups. Results After 9 months of follow-up,the overall efficacy rate was 79. 4% in the observation group,which was higher than 55. 9% of the control group(P < 0. 05). There was no significant difference in the incidence of adverse reactions(abnormal liver function,rash,oral mucositis,nausea and vomiting,thrombocytopenia,leukopenia,etc.) between the two groups(P > 0. 05). Conclusion The targeted therapy of three-dimensional conformal intensity modulated radiotherapy(cisplatin or nedaplatin) combined with chemotherapy with platinum and nituzumab for nasopharyngeal carcinoma has good short-term efficacy,safety and tolerance,which is worthy of clinical application.
Objective To investigate the efficacy of targeted therapy of three-dimensional conformal intensity modulated radiotherapy(cisplatin or nedaplatin) combined with chemotherapy with nituzumab for nasopharyngeal carcinoma(NPC). Methods A total of 68 patients with nasopharyngeal carcinoma admitted to Affiliated Hospital of Guangdong Medical University from January 2017 to January 2018 were selected as the subjects. According to the treatment methods,the patients were divided into an observation group and a control group,with 34 patients in each group. The patients in the observation group were treated with nituzumab targeted therapy on the basis of the three-dimensional conformal intensity modulated radiotherapy and synchronized chemotherapy with platinum. The patients in the control group were treated with three-dimensional conformal intensity modulated radiotherapy(cisplatin or nedaplatin) and platinum-based chemotherapy. The curative efficacy and incidence of adverse reactions were compared between the two groups. Results After 9 months of follow-up,the overall efficacy rate was 79. 4% in the observation group,which was higher than 55. 9% of the control group(P < 0. 05). There was no significant difference in the incidence of adverse reactions(abnormal liver function,rash,oral mucositis,nausea and vomiting,thrombocytopenia,leukopenia,etc.) between the two groups(P > 0. 05). Conclusion The targeted therapy of three-dimensional conformal intensity modulated radiotherapy(cisplatin or nedaplatin) combined with chemotherapy with platinum and nituzumab for nasopharyngeal carcinoma has good short-term efficacy,safety and tolerance,which is worthy of clinical application.
引文
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[15]王新森.尼妥珠单抗联合奈达铂同期三维适形放疗治疗局部晚期鼻咽癌疗效分析[J].肿瘤基础与临床,2017,30:325-327.
[2] Mitani A,Jo T,Yasunaga H,et al. Venous thromboembolic events in patients with lung cancer treated with cisplatin-based versus carboplatin/nedaplatin-based chemotherapy[J]. Anticancer Drugs,2018,29:560-564.
[3] Spatola C,Tocco A,Pagana A,et al. Combined taxane-based chemotherapy and intensity-modulated radiotherapy with simultaneous integrated boost for gastroesophageal junction adenocarcinoma[J]. Future Oncol,2018,14:47-51.
[4] Ezoe Y,Mizusawa J,Katayama H,et al. An integrated analysis of hyponatremia in cancer patients receiving platinum-based or nonplatinum-based chemotherapy in clinical trials(JCOG1405-A)[J]. Oncotarget,2017,9:6595-6606.
[5]陈伙辉,苏木兰,韦文浩,等.调强适形放疗联合顺铂化疗治疗鼻咽癌的疗效观察[J].中国肿瘤临床与康复,2017,24:1369-1372.
[6]邱杨,周振萍,钟晓鸣.顺铂与奈达铂同期放化疗治疗局部晚期鼻咽癌的疗效对比[J].中国肿瘤临床与康复,2017,24:1466-1468.
[7]李云.鼻咽癌初治患者调强放射治疗远期疗效及预后影响因素[J].中国肿瘤临床与康复,2017,4:55-58.
[8]徐莹,任雪,阎英.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,2018,46:267-271.
[9]林俞丞,郭立兵,林王美.尼妥珠单抗联合放化疗治疗晚期鼻咽癌的临床疗效分析[J].中国实用医药,2017,12:138-139.
[10]孙学明,吴慧,卢晓旭,等.奈达铂对比顺铂化疗联合IMRT治疗非高发区局部晚期鼻咽癌临床观察[J].中华放射医学与防护杂志,2018,38:836-841.
[11]刘新彦,李建斌,李志强,等.尼妥珠单抗联合顺铂治疗鼻咽癌的临床研究[J].中国临床药理学杂志,2018,34:1504-1507.
[12]马雄辉,王晓慧,修良昌,等.奈达铂加氟尿嘧啶同期放疗与顺铂同期放疗治疗局部晚期鼻咽癌的疗效比较[J].实用医学杂志,2017,33:181-184.
[13]赵光普.尼妥珠单抗联合顺铂同步放化疗治疗中晚期鼻咽癌的近期效果[J].河南医学研究,2018,27:143-144.
[14]吴志瑛,舒禹先.尼妥珠单抗联合顺铂及氟尿嘧啶治疗晚期鼻咽癌的效果[J].中国当代医药,2018,25:143-145.
[15]王新森.尼妥珠单抗联合奈达铂同期三维适形放疗治疗局部晚期鼻咽癌疗效分析[J].肿瘤基础与临床,2017,30:325-327.