重组人表皮生长因子预防鼻咽癌放射性口腔黏膜炎和急性放射性皮炎的疗效观察

doi:10.6040/j.issn.1673-3770.0.2016.203

摘要/Abstract

摘要： 目的观察重组人表皮生长因子(rhEGF)预防鼻咽癌(NPC)放射性口腔黏膜炎和急性放射性皮炎的临床疗效。方法将2014年1月至2015年12月收治的50例鼻咽癌患者(Ⅱ期5例,Ⅲ期32例,Ⅳa期13例)随机分为试验组(n=26)和对照组(n=24),两组全程均给予调强放射治疗,放疗周期6周,对照组同时采用顺铂单药化疗,每7 d为一周期,化疗周期为5~6周期;试验组在对照组的治疗基础上同期联合重组人表皮生长因子(口腔喷雾和颈部皮肤涂抹凝胶)进行治疗。以完全缓解、部分缓解、疾病稳定和疾病进展评价两组近期疗效,并采用美国国立癌症研究所常规毒性判定标准对不良反应进行评定。结果两组近期疗效基本相当(P>0.05);两组未出现因不良反应致死的情况;两组患者在治疗过程中出现的不良反应率基本相当,均以消化道毒性、骨髓抑制、肝功异常为主;两组患者均发生Ⅰ级以上的放射性口腔黏膜炎和颈部急性放射性皮炎,试验组中Ⅱ级以上放射性口腔黏膜炎和急性放射性皮炎的发生率(42.31%和11.54%)均明显低于对照组(70.83%和41.67%),差异均有统计学意义(P=0.042,0.035)。结论重组人表皮生长因子同期联合放化疗治疗鼻咽癌可以有效降低放化疗所致的放射性口腔黏膜炎和颈部急性放射性皮炎等不良反应的发生率。

关键词: 重组人表皮生长因子, 放射性口腔黏膜炎, 颈部急性放射性皮炎, 鼻咽癌

Abstract: Objective To observe the efficacy of recombinant human epidermal growth factor(rhEGF)in prevention of radioactive oral mucosa inflammation and acute radiation dermatitis of nasopharyngeal carcinoma(NPC). Methods A total of 50 NPC patients(5 stage Ⅱ, 32 stageⅢ and 13 stage Ⅳa)in the department of radiation oncology of our hospital hospitalized from January 2014 to December 2015 were randomly divided into the experimental group(n=26)and the control group(n=24).The two groups were treated with intensity modulated radiation therapy on the whole course, 6 weeks a radiotherapy cycle. The control group was given cisplatin single agent chemotherapy, and every 7 days for a cycle, 5 to 6 cycles. On the basis of the treatment of the control group, the experimental group was treated with combination of rhEGF(oral spray and neck skin smear gel)in the same period of the treatment. Short-term efficacy of the two groups was evaluated with complete remission, partial remission, stable disease and progression disease. The toxicity and side-effects were evaluated by the National Cancer Institute Common Toxicity Criteria(NCI-CTC). Results The short-term efficacy of the two groups was basically equivalent(P>0.05). No patients died in the two groups due to the toxic side effects, and the main toxicities in the two groups were gastrointestinal toxicity, myelosuppression and abnormal liver function. All patients had happened radioactive oral mucosa inflammation and acute radiation dermatitis of the neck which level was over grade Ⅰ. The incidence of radioactive oral mucosa inflammation and acute radiation dermatitis of the neck over grade Ⅱ level in the experimental group(42.31% and 11.54%)were significantly lower than those of the control group(70.83% and 41.67%)(P=0.042, 0.035). Conclusion The method of combination radiotherapy and chemotherapy with rhEGF in the treatment of NPC can effectively reduce the incidence of 山东大学耳鼻喉眼学报31卷1期 -于斌,等.重组人表皮生长因子预防鼻咽癌放射性口腔黏膜炎和急性放射性皮炎的疗效观察 \=-toxicity and side-effects of radioactive oral mucosa inflammation and acute radiation dermatitis of neck which caused by radiotherapy and chemotherapy.

Key words: Recombinanthuman epidermal growth factor, Radioactive oral mucosa inflammation, Nasopharyngeal carcinoma, Acute radiation dermatitis of the neck

中图分类号:

R739.63

于斌,郑青平,罗展雄,李旌,周媛媛,李中华,王磊黎,贺婵娟,石丰榕. 重组人表皮生长因子预防鼻咽癌放射性口腔黏膜炎和急性放射性皮炎的疗效观察[J]. 山东大学耳鼻喉眼学报, 2017, 31(1): 95-99.

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