Concurrent Chemoradiotherapy with or without Anti-EGFR-Targeted Treatment for Stage II-IVb Nasopharyngeal Carcinoma: Retrospective Analysis with a Large Cohort and Long Follow-up.
Concurrent Chemoradiotherapy with or without Anti-EGFR-Targeted Treatment for Stage II-IVb Nasopharyngeal Carcinoma: Retrospective Analysis with a Large Cohort and Long Follow-up.
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II-IVb 期鼻咽癌同步放化疗联合或不联合抗 EGFR 靶向治疗：大队列和长期随访的回顾性分析
DOI：
10.7150/thno.19710
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发表时间：
2017
期刊：
影响因子：
12.4
通讯作者：
Chen MY
中科院分区：
文献类型：
--
作者：
You R;Hua YJ;Liu YP;Yang Q;Zhang YN;Li JB;Li CF;Zou X;Yu T;Cao JY;Zhang MX;Jiang R;Sun R;Mo HY;Guo L;Cao KJ;Lin AH;Sun Y;Qian CN;Ma J;Chen MY
我们研究了抗EGFR靶向治疗、西妥昔单抗（CTX）或尼妥珠单抗（NTZ）联合铂类药物放化疗（CCRT）与单独CCRT相比在II-IVb期鼻咽癌（NPC）患者中的获益。共有1，628例符合条件的II-IVb期NPC患者在2009年6月至2013年12月期间接受了CCRT（每3周一次，100 mg/m2顺铂，3个周期，强度调节放射治疗），伴或不伴CTX或NTZ。使用倾向评分调整潜在的预后因素，通过将接受CTX或NTZ加CCRT的每例患者与不超过4例接受CCRT的患者（1：4）匹配，创建了878例患者的均衡队列。比较了CTX/NTZ联合CCRT与单独CCRT组之间的疗效和安全性。与单独CCRT相比，CTX/NTZ联合CCRT治疗与总生存率显著增加相关（3年OS，96.6% vs. 92.9%，P = 0.015），改善无病生存期（3年DFS，93.5% vs 86.9%，P = 0.028），并改善了无远处转移生存率（3年DMFS，94.6% vs 89.3%，P = 0.030）。CTX联合CCRT组中CTX相关皮肤反应和粘膜炎的发生率增加。多因素分析表明，CTX/NTZ联合使用是CCRT治疗患者OS、DFS和DMFS的重要保护因素。我们的分析表明，与单独CCRT相比，在CCRT中加入CTX/NTZ更有效地提高II-IVb期NPC患者的生存率。
We examined the benefits of the combination of anti-EGFR targeted treatment, cetuximab (CTX) or nimotuzumab (NTZ) and concurrent platinum-based chemoradiotherapy (CCRT) compared with CCRT alone in patients with stage II - IVb nasopharyngeal carcinoma (NPC). A total of 1,628 eligible patients with stage II - IVb NPC, who received CCRT (three cycles of 100 mg/m2 cisplatin every 3 weeks with intensity-modulated radiotherapy) with or without CTX or NTZ between June 2009 and December 2013 were included in the analysis. Using propensity scores to adjust for potential prognostic factors, a well-balanced cohort of 878 patients was created by matching each patient who received CTX or NTZ plus CCRT with no more than four patients who received CCRT alone (1:4). Efficacy and safety were compared between CTX/NTZ plus CCRT and CCRT alone arms. Compared with CCRT alone, treatment with CTX/NTZ plus CCRT was associated with a significantly increased overall survival (3-year OS, 96.6% vs. 92.9%, P = 0.015), improved disease-free survival (3-year DFS, 93.5% vs 86.9%, P = 0.028), and improved distant metastasis-free survival (3-year DMFS, 94.6% vs 89.3%, P = 0.030). Increased rate of CTX related-skin reaction and mucositis was observed in the CTX plus CCRT arm. Multivariate analysis demonstrated the combination of CTX/NTZ was a significant protective factor for OS, DFS, and DMFS in patients treated with CCRT. Our analysis suggests that the addition of CTX/NTZ to CCRT is more effective for maximizing survival in patients with stage II-IVb NPC compared with CCRT alone.
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影响因子：
4
作者：
Zhai RP;Ying HM;Kong FF;Du CR;Huang S;Zhou JJ;Hu CS
通讯作者：
Hu CS
影响因子：
51.1
作者：
Chen, Lei;Hu, Chao-Su;Ma, Jun
通讯作者：
Ma, Jun
影响因子：
45.3
作者：
Baselga, J;Trigo, JM;Eckardt, A
通讯作者：
Eckardt, A
影响因子：
50.5
作者：
Ma, B. B. Y.;Kam, M. K. M.;Chan, A. T. C.
通讯作者：
Chan, A. T. C.
与传统二维放疗相比，调强放疗延长鼻咽癌患者的生存期：大队列、长期随访的10年经验
影响因子：
8.4
作者：
Zhang, Meng-Xia;Li, Jing;Chen, Ming-Yuan
通讯作者：
Chen, Ming-Yuan