放疗同步联合尼妥珠单抗靶向治疗食管癌的初步临床观察

Initial clinical outcome in patients with esophageal cancer after radiotherapy combined with nimotuzumab

  • 摘要: 目的 探讨放疗联合尼妥珠单抗治疗食管癌的近期疗效, 生存率以及不良反应。 方法 回顾性分析我院2009-2012年经病理证实的34例食管鳞癌患者, 其中根治性放疗24例, 术后放疗10例, 采用三维适形放疗 (three dimensional conformal radiotherapy, 3DCRT) 或调强放射治疗 (intensity madulated radiation therapy, IMRT) , 放疗剂量60~70 Gy, 30~35次, 5次/周。放疗同步联合尼妥珠单抗静脉滴注200 mg/次, 1次/周, 放疗前给药。采用RTOG/EROTC标准评价正常组织放射反应。 结果 根治性放疗组生存期满1年13例, 2年5例, 中位生存期15个月, 近期疗效评价完全缓解 (CR) 8/24, 部分缓解 (PR) 10/24, 无缓解 (NR) 6/24, 中位生存期分别为38个月, 15个月, 9个月 (χ2=9.55, P=0.008) 。术后放疗组生存期满1年6例, 2年3例, 平均生存期37个月。尼妥珠单抗联合放疗未引起过敏、皮疹、腹泻等药物反应。 结论 放疗联合尼妥珠单抗治疗食管癌安全有效。

     

    Abstract: Objective To study the short-term curative effect,survival rate and adverse reactions in patients with esophageal cancer after radiotherapy combined with nimotuzumab. Methods The clinical data about 34 patients with pathology-confirmed esophageal squamous cancer admitted to our hospital from 2009 to 2012 were retrospectively analyzed.The patients were divided into radical radiotherapy group(n=24) and postoperative radiotherapy group(n=10).The patients received 3DCRT or IMRT at the dose of 6070 Gy,5 times a week for 30-35 times.Nimotuzumab was given by intravenous drip at the dose of 200 mg,once a week before radiotherapy.Radio-reactions of normal tissues were assessed according to the RTOG/EORTC criteria. Results Of the 24 patients in radical radiotherapy group,13 survived 1 year and 5 survived 2 years with a mean survival time of 15 months.Short-term effect assessment showed that the curative,partial and no effect were achieved in 8,10 and 6 out of the 24 patients,respectively,with mean survival time of 38,15 and 9 months(χ2=9.55,P=0.008).Of the 10 patients in postoperative radiotherapy group,6 survived 1 year and 3 survived 2 years with mean survival time of 37 months.No adverse reactions,such as allergic reaction,skin rush and diarrhea occurred after radiotherapy combined with nimotuzumab. Conclusion Radiotherapy combined with nimotuzumab is safe and effective modality for esophageal cancer.

     

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