Comparison of efficacy and adverse reactions between radiotherapy combined with cisplatin and radiotherapy combined with nimotuzumab in treatment of locally advanced nasopharyngeal carcinoma
Department of Radiation Oncology,First Affiliated Hospital of Xiamen University,Xiamen Tumor Hospital,Xiamen 361003,China (Liao XY,Zheng H,Dai MM,Wang LCH,LIn Q); Department of Radiation Oncology,Cnacer Hospital,Fudan University,Shanghai 200032,China (Kong L); Department of Radiation Oncology,Shanghai Proton and Heavy Ion Center,Shanghai 201315,China (Kong L,Lu JD)
Abstract： Objective To evaluate the efficacy and adverse reactions of radiotherapy combined with cisplatin or nimotuzumab after induction chemotherapy with docetaxel,cisplatin,and 5-fluorouracil (TPF) for locally advanced nasopharyngeal carcinoma. Methods Sixty patients with stage Ⅲ-Ⅳb nasopharyngeal carcinoma were randomly divided into experimental group (n=28) and control group (n=32). The two groups received radiotherapy after three cycles of induction chemotherapy with TPF. The control group received cisplatin during radiotherapy at a dose of 40 mg/m2,once a week,for 7 weeks,while the experimental group received nimotuzumab one week before radiotherapy at a dose of 200 mg,once a week,for 7 weeks. Survival analysis was used with the Kaplan-Meier method and log-rank test,efficacy and adverse reactions comparing were used with χ2 test. Results The short-term treatment outcomes were evaluated at three months after treatment. There were no significant differences in the complete or partial response rates between the control group and the experimental group (97% vs. 96% or 3% vs. 4%,P=0.923). There were no significant differences in 3-year progression-free survival or overall survival rate between the control group and the experimental group (88% vs. 79%,P=0.352;97% vs. 89%,P=0.268) The experimental group had significantly lower incidence rates of marrow suppression,severe fatigue,nausea,and vomiting than the control group (P=0.002,0.008,0.001). Conclusions There is no significant difference in clinical efficacy between radiotherapy combined with cisplatin and radiotherapy combined with nimotuzumab in the treatment of locally advanced nasopharyngeal carcinoma. However,radiotherapy combined with targeted therapy achieves significantly fewer adverse reactions.
Liao Xiyi,Kong Lin,Zheng Hua et al. Comparison of efficacy and adverse reactions between radiotherapy combined with cisplatin and radiotherapy combined with nimotuzumab in treatment of locally advanced nasopharyngeal carcinoma[J]. Chinese Journal of Radiation Oncology, 2016, 25(12): 1277-1280.
[1] 高黎,易俊林,徐国镇,等.鼻咽癌根治性放疗 10年经验总结[J].中华放射肿瘤学杂志,2006,15(4):249-255. Gao L,Yi JL,Xu GZH,et al. Ten-year experience of radical radiotherapy for nasopharyngeal carcinoma:analysis of 905 patients[J].Chin J Radit Oncol,2006,15(4):249-255. [2] Chua DT,Shan JS,Kwong DL,et al. Treatment outcome after radiotherapy alone for patients with Stage Ⅰ-Ⅱ nasophryngeal carcinoma[J].Cancer,2003,98(1):74-80. [3] Chow E,Payne D,O’Sullivan B,et al. Radiatherapy alone in patients with advanced nasopharyngeal cancer:comparison with an intergroup study. Is combined modality treatment really necessary[J]? Radiother Oncol,2002,63(3):269-274. [4] Chua DT,Shan JS,Wei WJ,et al. The predictive value of the 1997 American Joint Committee on Cancer stage classification in determining failure patterns in nasopharyngeal carcinoma[J].Cancer,2001,92(11):2845-2855. [5] Zhong YH,Dai J,Wang XY,et al. Phase Ⅱ trial of neoadjuvant docetaxel and cisplatin followed by intensity-modulated radiotherapy with concurrent cisplatin in locally advanced nasopharyngeal carcinoma[J].Cancer Chemother Pharmacol,2013,71(6):1577-1583. [6] Du C,Ying H,Zhou J,et al. Experience with combination of docetaxel,cisplatin plus 5-fluorouracil chemotherapy,and intensity-modulated radiotherapy for locoregionally advanced nasopharyngeal carcinoma[J].Int J Clin Oncol,2013,18(3):464-471.10.1007/s10147-012-0403-y. [7] Fan TY,Xing J,Lu J,et al. Phase Ⅰ/Ⅱ study of induction chemotherapy plus concurrent chemotherapy and SMART-IMRT-based radiotherapy in locoregionally-advanced nasopharyngeal cancer[J].Oncol Lett,2013,5(3):889-895. [8] Chen C,Zhao C,Gao L,et al. An open-labeled,multicentric clinical study of cetuximab combined with intensity-modulated radiotherapy (IMRT) plus concurrent chemotherapy in locoregionally advanced (LA) nasopharyngeal carcinoma (NPC):a 2-year follow-up report[J].J Clin Oncol,2012,30(15):5535. [9] Ma BBY,Kam MKM,Leung SF,et al. A phase Ⅱ study of concurrent cetuximab-cisplatin and intensity-modulated radiotherapy in locoregionally advanced nasopharyngeal carcinoma[J].Ann Oncol,2011,23(5):1287-1292.10.1093/annonc/mdr401. [10] Lorch JH,Goloubeva O,Haddad RI,et alInduction chemotherapy with cisplatin and fluorouraeil alone or in combination with docetaxel in locally advanced squamous-cell cancer of the head and neck:long-term results of the TAX 324 randomised phase 3 trial[J].Lancet Oncol,2011,12(2):153-159.10.1016/S1470-2045(10)70279-5. [11] 王树森,管忠震,向燕群,等.鼻咽癌组织中EGFR和P-ERK蛋白表达的检测及意义[J].中华肿瘤杂志,2006,28(1):28-31. Wang SHS,Guan ZHZH,Xiang YQ,et al. Detection and significance of EGFR and P-ERK protein expression in nasopharyngeal carcinoma[J].Chin J Oncol,2006,28(1):28-31. [12] Modjtahedi H,Essapen S.Epidermal growth factor recept inhibitors in cancer treatment:advances,challenges and opportunities[J].Anticancer Drugs,2009,20(10):851-855.10.1097/CAD.0b013e3283330590. [13] Talavera A,Friemann R,Gomez Puerta S,et alNimotuzumab,an antitumor antibody that targets the epiderm al growth factor receptor,blocks lig and binding while permitting the active receptor conformation[J].Cancer Res,2009,69(14):5851-5859.10.1158/0008-5472.CAN-08-4518. [14] 黄晓东,易俊林,高黎,等.抗表皮生长因子受体单克隆抗体h-R3联合放疗治疗晚期鼻咽癌的Ⅱ期临床研究[J].中华肿瘤杂志,2007,29(3):197-200. Huang XD,Yi JL,Gao L,et al. Clinical Ⅱ stage study of anti epidermal growth factor receptor monoclonal antibody h-R3 combined with radiotherapy in the treatment of advanced nasopharyngeal carcinoma[J].Chin J Oncol,2007,29(3):197-200. [15] Bonner JA,Harari PM,Giralt J,et alRadiotherapy plus Cetuximab for squamous cell carcinoma of the head and neck[J].N Engl J Med,2006,354(6):567.
2016, Vol. 25 
