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目的观察调强适形放射治疗联合西妥昔单抗对中晚期鼻咽癌的临床疗效。方法 40例鼻咽癌晚期患者随机分为试验组与对照组,各20例。对照组接受调强适形放射治疗(IMRT)+化疗治疗方案,放疗同时给予顺铂治疗;试验组在对照组的基础上加用西妥昔单抗治疗。治疗结束后比较2组患者的临床缓解率和外周血T淋巴细胞亚群,并观察不良反应发生情况。随访3年,记录患者肿瘤复发和死亡情况。结果试验组总缓解率为55.0%,显著高于对照组的30.0%(P<0.05)。与对照组比较,试验组CD4~+与CD8~+含量差异无统计学意义(P>0.05),CD4~+/CD8~+倒置情况差异无统计学意义。2组皮炎、消化道反应、超敏反应等不良反应发生率差异无统计学意义(P>0.05);口腔黏膜反应发生率试验组显著高于对照组(P<0.05)。对2组患者进行3年的随访,随访第1年试验组与对照组的生存率差异无统计学意义(P>0.05);试验组2、3年生存率均明显高于对照组(P<0.05)。结论调强适形放疗联合西妥昔单抗治疗中晚期鼻咽癌临床效果好,远期复发率和不良反应发生率低。
Objective To observe the clinical effect of intensity modulated conformal radiotherapy combined with cetuximab on advanced nasopharyngeal carcinoma. Methods Forty patients with advanced nasopharyngeal carcinoma were randomly divided into experimental group and control group, with 20 cases in each. The control group received intensity-modulated conformal radiotherapy (IMRT) and chemotherapy regimen. Radiotherapy was given concurrently with cisplatin. The experimental group was treated with cetuximab on the basis of the control group. After treatment, the clinical remission rate and peripheral blood T lymphocyte subsets were compared between the two groups, and the occurrence of adverse reactions was observed. Followed up for 3 years, recorded the patient’s tumor recurrence and death. Results The total remission rate was 55.0% in the experimental group, which was significantly higher than that in the control group (30.0%, P <0.05). Compared with the control group, there was no significant difference in the CD4 ~ + and CD8 ~ + contents in the experimental group (P> 0.05). There was no significant difference in the CD4 ~ + / CD8 ~ + inversions. There was no significant difference in the incidence of adverse events such as dermatitis, digestive tract reaction and hypersensitivity between the two groups (P> 0.05). The incidence of oral mucosa reaction in the experimental group was significantly higher than that in the control group (P <0.05). There was no significant difference in the survival rate between the two groups in the first year of follow-up (P> 0.05). The 2-year and 3-year survival rates of the two groups were significantly higher than those in the control group (P < 0.05). Conclusion Intensive conformal radiotherapy combined with cetuximab in the treatment of advanced nasopharyngeal carcinoma clinical effect is good, long-term recurrence rate and adverse reaction rate is low.