解放军医学杂志2024，Vol.49Issue(6)：623-628,6.DOI:10.11855/j.issn.0577-7402.0963.2024.0104
尼妥珠单抗联合TP方案诱导化疗对EGFR阳性局部晚期鼻咽癌的近期疗效及其安全性
Short-term efficacy of chemotherapy induced by nimotuzumab combined with TP regimen and sequential concurrent chemoradiotherapy in patients with EGFR-positive locally advanced nasopharyngeal carcinoma
摘要
Abstract
Objective To investigate the short-term efficacy and safety of chemotherapy induced by nimotuzumab(NTZ)combined with TP regimen and sequential concurrent chemoradiotherapy in patients with epidermal growth factor receptor positive(EGFR-positive)locally advanced nasopharyngeal carcinoma.Methods A total of 48 patients with stage Ⅲ to Ⅳ A nasopharyngeal carcinoma in Guizhou Provincial People's Hospital from January 2020 to December 2022 were prospectively enrolled,and were randomized into two groups:NTP(NTZ+docetaxel/albumin-paclitaxel+cisplatin)group and TP(Docetaxel/albumin-paclitaxel+cisplatin)group(24 cases per group)by random number table method.After 2 or 3 cycles of induction chemotherapy in NTP group,NTZ was sequentially used in combination with cisplatin for concurrent chemoradiotherapy.Immunohistochemistry was used to detect the EGFR expression level,exploring EGFR expression intensity and the therapeutic effect of NTZ in NTP group patients.Meanwhile,short-term efficacy,withdrawal rate and toxic side effects were compared between the two groups after induction chemotherapy.Results In NTP group,the positive expression rate of EGFR was 100％,and EGFR expression intensity significantly correlated with the efficacy of NTZ-combined induction therapy(P<0.05).After induction chemotherapy,the objective response rate(ORR)of cervical lymph nodes in NTP group was significantly higher than that in TP group(75％vs.45.8％,P=0.039).The primary lesion ORR and overall(primary lesion and cervical lymph node)ORR showed no significant difference between the two groups(P>0.05).Comparison of adverse reactions between the two groups during induction therapy:leukopenia and gastrointestinal reaction in NTP group were lower than those in TP group(P<0.05),but rash was higher than those in TP group(P<0.05).There was no significant difference in liver function,hemoglobin and thrombocytopenia between two groups(P>0.05).Conclusions EGFR expression intensity varies in nasopharyngeal carcinoma tissues,with higher levels indicating greater clinical benefit of combined induction therapy with NTZ.NTZ combined with TP induction regimen demonstrates good short-term efficacy and safety for cervical lymph nodes in patients with locally advanced nasopharyngeal carcinoma.关键词
鼻咽癌/诱导化疗/表皮生长因子受体/尼妥珠单抗/不良反应Key words
nasopharyngeal carcinoma/induction chemotherapy/EGFR/nimotuzumab/adverse reactions分类
临床医学引用本文复制引用
宋娟,孙轶,廖加群,何馨云,黄立敏,雷竹,李源丽,朱海振..尼妥珠单抗联合TP方案诱导化疗对EGFR阳性局部晚期鼻咽癌的近期疗效及其安全性[J].解放军医学杂志,2024,49(6):623-628,6.基金项目
This work was supported by the National Natural Science Foundation of China(82260357),and the Guizhou Provincial Science and Technology Plan Project[Qian-basic(2020)1Y428,Qian-support(2021)General093] 国家自然科学基金(82260357) （82260357）
贵州省科技计划项目(黔科合基础[2020]1Y428,黔科合支撑[2021]一般093) （黔科合基础[2020]1Y428,黔科合支撑[2021]一般093）
