[用于口腔状细胞癌的诱导化疗与并发化疗和放射性化疗的临床研究]
1College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Chinese PLA Medical School, China National Clinical Research Center for Otolaryngologic Diseases State Key Lab of Hearing Science, Ministry of Education, China Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing 100853, China.
概括
非手术综合疗法,包括诱导化疗和EGFR抑制剂的化疗放射治疗,对于晚期口腔状细胞癌 (OPSCC) 是有效的. 人类乳头瘤病毒 (HPV) 阳性 (p16+) 患者的生存率明显优于HPV阴性 (p16-) 患者.
科学领域:
- 在瘤学瘤学.
- 头部和部手术 头部和部手术
- 癌症治疗方法 癌症治疗方法
背景情况:
- 局部发达的口腔状细胞癌 (OPSCC) 存在重大治疗挑战.
- 人类乳头瘤病毒 (HPV) 状态越来越被认为是OPSCC的关键预后因素.
研究的目的:
- 评估高级OPSCC的非手术综合治疗的疗效和安全性.
- 为了确定HPV状态 (p16表达) 对患者结局的影响.
主要方法:
- 对152名先进OPSCC患者的回顾性分析,这些患者接受了诱导化疗 (IC) +并发化疗 (CCRT) ±表皮生长因子受体 (EGFR) 抑制剂.
- 治疗包括尼莫图祖马布,塞图西马布或PD-1免疫疗法. 放射治疗利用了螺旋式断层疗法 (HT) 和强度调节放射疗法 (IMRT).
- 使用卡普兰-梅尔和考克斯回归分析的生存率;通过CTCAE v5.5评估的不良事件.
主要成果:
- 两年和三年总生存率分别为86.8%和74.6%;无进展生存率分别为83.5%和73.3%.
- 与p16-患者 (n=33) 相比,p16+患者 (n=71) 的2年生存率 (98.9%) 和3年生存率 (93.2%) 显著更高 (分别为77.2%和61.4%).
- 3级口喉粘膜炎发生在83.3%的患者中,通常耐受良好,需要最小的营养支持.
结论:
- 非手术综合疗法 (IC+CCRT±EGFR抑制剂) 是高级OPSCC的有效治疗方法.
- p16+状态与高级OPSCC中优异的生存结果有关.
- 治疗方案通常被患者容忍得很好.
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