Treatment Outcomes Of 257 Patients With Locally Advanced Nasopharyngeal Carcinoma Treated With Nimotuzumab Plus Intensity-Modulated Radiotherapy With Or Without Chemotherapy: A Single Institution Experience.

JOURNAL OF CLINICAL ONCOLOGY(2017)

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摘要
6079 Background: To report the long-term outcome and toxicitie of locally advanced nasopharyngeal carcinoma (NPC) treated with nimotuzumab plus intensity- modulated radiotherapy (IMRT) with or without chemotherapy. Methods: From October 2009 to March 2014, 257 newly histology-proven, non-metastatic NPC patients were retrospectively enrolled. They are aged 10-76 years. The distribution of disease was stage III in 150 (58.4%), stage IV A in 88 (34.2%), and stage IV B in 19 (7.4%). All the patients received the treatment of nimotuzumab plus IMRT, and 239 cases were used for cisplatin-based chemotherapy. Acute and late radiation-related toxicities were graded according to the Acute and Late Radiation Morbidity Scoring Criteria of Radiation Therapy Oncology Group. The accumulated survival was calculated according to the Kaplan-Meier method. Log-rank test was used to compare the survival difference. Multivariate analysis was performed using Cox’s proportional hazard model. Results: All patients had completed the combined treatment. With a median follow-up of 48 months (range, 13–94 months), the estimated 3-year and 5-year overall survival rates were 92.6% and 86.2%, respectively. Univariate analysis showed that age, T stage, clinical stage and neoadjvant chemotherapy were related with OS. Multivariate analysis indicated that age and clinical stage were independent prognosticators. The median cycle for nimotuzumab addition was 12 weeks. The incidence of grade 3–4 acute mucositis and leukocytopenia were 10.9% and 9.3%, respectively, with no cases of skin rash and infusion reaction. Xerostomia was the most common late complication, and the degree of dry mouth in most survivors was mild-to-moderate at the last follow-up time. Conclusions: Nimotuzumab plus IMRT with or without chemotherapy showed promising outcomes in terms of loco-regional control and survival, without increasing the incidence of radiation-related toxicities for patients.
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关键词
Radiotherapy,Nasopharyngeal Carcinoma
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