尼妥珠单抗联合PF方案诱导治疗局部晚期鼻咽癌的多中心临床研究
DOI: 10.3971/j.issn.1000-8578.2019.18.2031
刘文其,
刘美莲,
宁雪坚,
梁锦辉,
王仁生,
罗展雄,
陆颖,
陈达桂,
高健全,
黄昌杰,
黄海欣
Keywords: 鼻咽癌,EGFR单抗,诱导治疗,疗效,不良反应,Therapeutic Effect of Elemene Combined with Chemoradiotherapy and Its Influence on Immune Function in Nasopharyngeal Carcinoma Patients,Adverse Reaction of HIPEC Combined with Intravenous Chemotherapy on Ovarian Cancer Patients,Value of 18F-FDG PET/CT in Evaluating Chemotherapeutic Effect of Diffuse Large B Cell Lymphoma Patients with Different CD5 Expression,Comparison of Thoracoscopic Versus Open Thymectomy in Treatment of Large Thymoma During Perioperative Period,Efficacy and Prognostic Factors of Docetaxel Rechallenge on Metastatic Castrationresistant Prostate Cancer Patients,Progress on Comprehensive Treatment of Nasopharyngeal Cancer,Efficacy and Prognostic Factors of Docetaxel Combined with ADT on Metastatic Hormone-sensitive Prostate Cancer Patients,Expression and Biological Functions of Sestrin2 in Nasopharyngeal Carcinoma,Prognostic Effects of Different Courses of Neoadjuvant Chemotherapy on Stage N2-3 Locally Advanced Nasopharyngeal Carcinoma,RNA PolymeraseⅠInhibitor Regulates Proliferation, Invasion and Apoptosis of Nasopharyngeal Carcinoma Cell Line CNE-1 by NF-κb,Research Progress of Combination Therapy of Apatinib on Tumor,Effect of Modified Yangyin Qingfei Decoction Combined with Nutritional Intervention on Nutritional Status and Curative Effect of Nasopharyngeal Carcinoma Patients Undergoing Radiotherapy,Evaluation of 192Ir-Based Hypofractionated Stereotactic Ablative Brachytherapy as A Neoadjuvant Treatment for Operable Peripheral Non-small Cell Lung Cancer,Metadherin-mediated Cell Proliferation and Paclitaxel Resistance in Nasopharyngeal Carcinoma,Relationship of Peripheral Blood Neutrophil/Lymphocyte Ratio and Platelet/Lymphocyte Ratio with Curative Effect and Prognosis of Patients with Locally Advanced Nasopharyngeal Carcinoma
Abstract:
摘要 目的 探讨尼妥珠单抗联合PF方案（顺铂+氟尿嘧啶）的诱导治疗在后续接受同期放化疗的局部晚期鼻咽癌患者中的安全性及作用。方法 118例Ⅲ~Ⅳa期鼻咽癌患者纳入研究，随机分为NPF组58例（尼妥珠单抗联合PF方案诱导治疗组）和TPF组60例（多西他赛、顺铂、氟尿嘧啶方案诱导化疗组），2周期诱导治疗后，所有患者均接受顺铂同期的调强放射治疗（IMRT），比较两组的安全性、近期疗效。结果 与TPF组比较，NPF组诱导治疗对于颈部淋巴结有更显著的疗效（P=0.036）；而诱导治疗的原发病灶疗效、诱导治疗的总体疗效和全程治疗结束的即刻疗效评价比较，差异均无统计学意义（P>0.05）。诱导治疗期间，中性粒细胞减少、胃肠道反应较TPF组均显著改善（P=0.028, P=0.049）。同期放化疗阶段，与TPF组比较，NPF组的胃肠道反应、口腔黏膜炎及放射性皮炎均显著改善（P=0.038, P=0.041, P=0.035）。结论 对于后续接受顺铂同期IMRT治疗的局部晚期鼻咽癌，尼妥珠单抗联合PF方案的诱导治疗具有更好的淋巴结缓解率，且不良反应更轻微；患者在后续的同期放化疗中耐受性更好，但远期疗效需要进一步随访观察
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