Treatment of nasopharyngeal carcinoma with combined helical tomotherapy and anti-EGFR monoclonal antibody

Objective To study the short-term outcome and adverse reactions of combined helical tomotherapy and anti-EGFR monoclonal antibody in patients with nasopharyngeal carcinoma（NPC）. Methods Clinical data about 34 NPC patients who underwent helical tomotherapy in our hospital from March 2008 to November 2009 were retrospectively analyzed.Gross tumor volume（pGTVnx） with visible lymphnodes（GTVnd） underwent helical tomotherapy at the dose of 70Gy for 33 fractions,high risk clinical target volume（PTV1） received helical tomotherapy at the dose of 60Gy for 33 fractions,and low risk clinical target volume（PTV2） accepted helical tomotherapy at the dose of 56Gy for 33 fractions.Of the 34 patients,17 underwent combined helical tomotherapy and nimotuzumab（200mg）,once a week for 6-7 weeks,and 17 received combined helical tomotherapy and cetuximab（400mg/m2） followed by 250mg/m2,once a week for 6-7 weeks.Their clinical outcomes were assessed according to RECIST 1.0 and acute reactions were assessed following the RTOG/EORTC criteria. Results The patients were followed up for 27-48 months（mean 36 months）.The 1-,2and 3-year survival rates of patients with local and lymph node relapse,and the overall survival（OS） rate of patients with distant metastasis were 0,0,17.6% and 88.2% in combined helical tomotherapy and nimotuzumab group and 0,0,11.8% and 100% in combined helical tomotherapy and cetuximab group（P＞0.05）.The incidence of mucosal reaction（u=2.25,P＜0.05）,weight loss（t=2.56,P=0.02） and rash（u=4.36,P＜0.01） was higher in combined helical tomotherapy and nimotuzumab group than in combined helical tomotherapy and cetuximab group. Conclusion No significant difference can be found in 1-,2-and 3-year survival rates in NPC patients after combined helical tomotherapy and nimotuzumab or cetuximab.The acute reaction to nimotuzumab is milder than that to cetuximab and tolerable in NPC patients.