摘要
目的探讨新辅助化疗后尼妥珠单抗联合调强放射治疗局部晚期鼻咽癌的疗效和不良作用。方法中晚期鼻咽癌患者38例，应用多西紫杉醇、DDP、5-Fu新辅助化疗2个疗程后，采用尼妥珠单抗联合调强放射治疗，尼妥珠单抗针100mg自放疗第1天开始，静脉滴注，1次／周，共6～8次；放疗采用6MVX线照射，全程应用调强放射治疗技术，DT66-70．4Gy/30～32次，6-7周完成。观察治疗的疗效和不良反应。结果放疗结束后3个月鼻咽部CR84.2％，PR15．8％；颈部淋巴结CR 86.8％，PR13．2％。1、2、3年生存率和无进展生存率分别为100％和933％、85．4％和80．2％、74．9％和64．2％。早期主要不良反应为骨髓抑制、恶心呕吐、口腔黏膜炎和脱发；晚期主要是口干和颈部肌肉纤维化。结论新辅助化疗后尼妥珠单抗联合调强放疗治疗局部晚期鼻咽癌疗效较好，不良反应少，患者可耐受，适合局部晚期鼻咽癌的治疗。
Objective To Investigate the efficacy and side effects of nimotuzumab after neoadjuvant chemotherapy combined IMRT （ intensity modulated radiotherapy ） to the advanced nasopharyngeal carcinoma. Methods The patients accounted for 38 cases of newly diagnosed patients with advanced nasopharyngeal carcinoma from March 2011 to March 2014, At the first the patients are accepted two cycles of neoadjuvant chemotherapy of doeetaxel, DDP, 5-Fu ~ then nimotuzumab combined IMRT radiotherapy. Nimotuzumab was given intravenousy with a dosage of 100rag weekly for a total of 6-8 times since the first day of radiotherapy. The radiotherapy is using 6MV X-ray IMRT technology, DT66-70.4 Gy/30-32 fractions, 6~7 weeks to complete. Result After 3 months radiotherapy, 84.2% achieved complete regression of primary tumor, 15.8% had partical regression; the patients with synchronous nodal disease 86.8% had complete regression and 13.2% had partical regression. The survival rates and the progression-free survival rates of 1, 2, 3-year were 100% and 93.3%, 85.4% and 80.2%, 74.9% and 64.2%. The early major side effect includes myelosuppression, nausea and vomiting, oral mucositis and alopecia, Then the later side effect includes dry mouth and neck muscle fibrosis. Conclusion The nimotuzumab after neoadjuvant chemotherapy combined IMRT is more suitable for the treatment of locally advanced nasopharyngeal carcinoma because of the better effects, the fewer side effects and tolerable.
出处
《浙江临床医学》
2016年第1期62-64,共3页
Zhejiang Clinical Medical Journal
