A phase II study of concurrent cetuximab-cisplatin and intensity-modulated radiotherapy in locoregionally advanced nasopharyngeal carcinoma
A phase II study of concurrent cetuximab-cisplatin and intensity-modulated radiotherapy in locoregionally advanced nasopharyngeal carcinoma
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DOI：
10.1093/annonc/mdr401
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发表时间：
2012-05-01
影响因子：
50.5
通讯作者：
Chan, A. T. C.
中科院分区：
文献类型：
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作者：
Ma, B. B. Y.;Kam, M. K. M.;Chan, A. T. C.
基于我们先前关于西妥昔单抗治疗复发性鼻咽癌（NPC）的临床活性的工作，我们评估了西妥昔单抗联合顺铂和调强放疗（IMRT）治疗局部晚期NPC的可行性。美国癌症联合委员会III-IVB期NPC患者给予西妥昔单抗初始剂量（400 mg/m（2））在接受同步IMRT前7-10天，顺铂每周一次（30 mg/m2/周）和西妥昔单抗入选30例（中位年龄45岁）非角化性NPC患者，III期（67%）、IVA期（30%）和IVB期（3%）。26例（87%）患者发生3-4级口咽粘膜炎，10例（33%）患者需要短期鼻饲。6例患者（20%）发生3级放疗相关皮炎，3例患者（10%）发生3级西妥昔单抗相关痤疮样皮疹。这些3-4级皮肤和粘膜毒性作用是可控和可逆的。中位随访31.8个月[95%可信区间（CI）26.2-32.1个月]，2年无进展生存率为86.5%（95%CI 74.3%~ 98.8%），西妥昔单抗、顺铂每周一次联合调强放疗是治疗局部晚期鼻咽癌的可行策略。初步生存数据与历史数据相比有利，需要进一步随访。
Based on our previous work on the clinical activity of cetuximab in recurrent nasopharyngeal carcinoma (NPC), we evaluated the feasibility of adding cetuximab to concurrent cisplatin and intensity-modulated radiotherapy (IMRT) in locoregionally advanced NPC.Patients with American Joint Committee on Cancer stage III-IVB NPC were given an initial dose of cetuximab (400 mg/m(2)) 7-10 days before receiving concurrent IMRT, weekly cisplatin (30 mg/m(2)/week) and cetuximab (250 mg/m(2)/week).Thirty patients (median age of 45 years) with stage III (67%), IVA (30%) and IVB (3%) nonkeratinizing NPC were enrolled. Grade 3-4 oropharyngeal mucositis occurred in 26 (87%) patients and 10 (33%) patients required short-term nasogastric feeding. Grade 3 radiotherapy-related dermatitis occurred in six patients (20%) and three patients (10%) had grade 3 cetuximab-related acneiform rash. These grade 3-4 skin and mucosal toxic effects were manageable and reversible. At a median follow-up of 31.8 months [95% confidence interval (CI) 26.2-32.1 months], the 2-year progression-free survival was 86.5% (95% CI 74.3% to 98.8%).Concurrent administration of cetuximab, weekly cisplatin and IMRT is a feasible strategy against locoregionally advanced NPC. Preliminary survival data compare favorably with historic data and further follow-up is warranted.