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尼妥珠单抗联合放射治疗对老年食管鳞癌患者的疗效分析
作者:张碧云  赵迪 
单位:南京中医药大学附属医院 放疗科, 江苏 南京 210029
关键词:食管鳞癌 尼妥珠单抗 放射治疗 老年肿瘤患者 
分类号:R735.1
出版年·卷·期(页码):2021·49·第五期(511-514)
摘要:

目的:探讨尼妥珠单抗联合放疗对老年食管鳞癌患者治疗的有效性和安全性。方法:选取2015年5月至2016年4月我院收治的27例病理确诊为食管鳞癌、年龄>70岁的患者为研究对象。患者不适合或拒绝手术及化疗而予尼妥珠单抗联合单纯放疗。患者行调强放疗同期使用尼妥珠单抗200 mg·周-1。评估临床疗效、毒副作用及远期生存情况。结果:27例患者均完成治疗计划。中位生存期及中位无进展生存期分别为17.0个月和16.0个月;2年和3年的总生存率分别为49.6%和37.2%,无疾病进展率分别为45.6%和21.4%。患者疗程中均出现1~2度放射性食管炎,无3度以上食管炎及血液学毒性发生。结论:尼妥珠单抗联合单纯放疗对老年食管鳞癌患者安全有效,但仍需扩大样本量进一步研究证实。

Objective: To investigate the effectiveness and safety of nitrozumab combined with radiotherapy in elderly patients with esophageal squamous carcinoma. Methods: 27 cases with pathologically confirmed esophageal squamous carcinoma(>70 years old) admitted to our hospital between May 2015 and April 2016 were selected for the study. Patients were unfit for or refused surgery and chemotherapy, and were treated solely with nitrozumab combined with radiotherapy. All patients were treated with intensity-modulated radiotherapy, and nitrozumab(200 mg·week-1) was administered along with radiotherapy. Clinical outcome, toxicities and long-term survival rates were assessed.Results: All 27 patients completed the treatment plan. The median survival and median progression-free survival were 17.0 months and 16.0 months, respectively. The overall survival at 2 and 3 years were 49.6% and 37.2%, respectively, and the rates of progression-free patients were 45.6% and 21.4% respectively. All patients developed radiation oesophagitis of degree 1 to 2 during the course of treatment, with no occurrence of oesophagitis above degree 3 or haematological toxicity.Conclusion: Nitrozumab combined with radiotherapy alone is safe and effective in treating elderly patients with esophageal squamous carcinoma, but further studies with expanded sample sizes are needed to consolidate this finding.

参考文献:

[1] CHEN W,ZHENG R,BAADE P D,et al.Cancer statistics in China,2015[J].CA Cancer J Clin,2016,66(2):115-132.
[2] RUSTGI A K,EL-SERAG H B.Esophageal carcinoma[J].N Engl J Med,2014,371(26):2499-2509.
[3] STEYERBERG E W,NEVILLE B,WEEKS J C,et al.Referral patterns,treatment choices,and outcomes in locoregional esophageal cancer:a population-based analysis of elderly patients[J].J Clin Oncol,2007, 25(17):2389-2396.
[4] 陆斌,瞿彩平,孙征,等.卡培他滨维持治疗晚期食管-胃交界处腺癌的临床观察[J].东南大学学报(医学版),2017,36(1):86-89.
[5] COOPER J S,GUO M D,HERSKOVIC A.Chemoradiotherapy of locally advanced esophageal cancer:long-term follow-up of a prospective radomized trial(RTOG85-01).Radiation Therapy Oncology Group[J].J Am Med Assoc, 1999,281(17):1623-1627.
[6] PANDE A U,IYER R V,RANI A,et al.Epidermal growth factor receptor-directed therapy in esophageal cancer[J].Oncology,2007,73(5-6):281-289.
[7] KONO K,MIMURA K,FUJII H,et al.Potential therapeutic significance of HER-family in esophageal squamous cell carcinoma[J].Ann Thorac Cardiovasc Surg,2012,18(6):506-513.
[8] CROMBET R T,RAK J,PEREZ R,et al.Antiproliferative,antiangiogenic and proapoptotic activity of h-R3:a humanized anti-EGFR antibody[J].Int J Cancer,2002,101(6):567-575.
[9] DE CASTRO-JUNIOR G,SEGALLA J G,DE AZEVEDO S J,et al.A randomised phase Ⅱ study of chemoradiotherapy with or without nimotuzumab in locally advanced oesophageal cancer:NICE trial[J].Eur J Cancer,2018,88(1):21-30.
[10] RAMOS-SUZARTE M,LORENZO-LUACES P,LAZO N G,et al.Treatment of malignant,non-resectable,epithelial origin esophageal tumours with the humanized anti-epidermal growth factor antibody nimotuzumab combined with radiation therapy and chemotherapy[J].Cancer Biol Ther,2012,13(8):600-605.
[11] ZHAO L,HE LR,XI M,et al.Nimotuzumab promotes radiosensitivity of EGFR-overexpression esophageal squamous cell carcinoma cells by upregulating IGFBP-3[J].J Transl Med,2012,10:249-257.
[12] 翟医蕊,惠周光,梁军,等.同步尼妥珠单抗联合放化疗治疗不可切除局部晚期食管鳞癌的疗效分析[J].中国临床医生杂志,2019, 47(9):1052-1055.
[13] LIANG J,MINGYAN E,WU G,et al.Nimotuzumab combined with radiotherapy for esophageal cancer:preliminary study of a Phase ii clinical trial[J].Onco Targets Ther,2013,6:1589-1596.
[14] ZHANG P,XI M,ZHAO L,et al.Is there a benefit in receiving concurrent chemoradiotherapy for elderly patients with inoperable thoracic esophageal squamous cell carcinoma[J].PLoS One,2014,9(8):e105720.
[15] ISHIDA K,ANDO N,YAMAMOTO S,et al.Phase Ⅱ study of cisplatin and 5-fluorouracil with concurrent radiotherapy in advanced squamous cell carcinoma of the esophagus:a Japan Esophageal Oncology Group (JEOG)/Japan Clinical Oncology Group trial(JCOG9516)[J].Jpn J Clin Oncol,2004,34(10):615-619.
[16] HAN J,ZHU W,TU C,et al.Clinical study of concurrent chemoradiotherapy or radiotherapy alone for esophageal cancer patients with positive lymph node metastasis[J].Tumori,2012,98(1):60-65.
[17] SEMRAU R,HERZOG S L,VALLBÖHMER D,et al.Radiotherapy in elderly patients with inoperable esophageal cancer.Is there a benefit[J].Strahlenther Onkol,2012,188(3):226-232.
[18] TAKEUCHI S,OHTSU A,DOI T,et al.A retrospective study of definitive chemoradiotherapy for elderly patients with esophageal cancer[J].Am J Clin Oncol,2002,30(6):607-611.

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