Cisplatin With Or Without Nimotuzumab Concurrent Radiotherapy In The Treatment Of Patients With Locally Advanced Cervical Cancer

Cervical cancer is the second most common malignancy among women, and is a major cause of morbidity and mortality. Concurrent platinum-based chemoradiation is the standard treatment for locally advanced cervical cancer. Unfortunately, most responses are partial and of short duration, more than35%of patients overall will develop persistent, recurrent or metastatic disease. We need to find new drugs or methods to improve the outcome. Some studies found that the epidermal growth factor receptor (EGFR) overexpressed in cervical tumor, associated with cytotoxic drugs and radiation resistance. Studies in vitro and vivo have found that blocking the EGFR could increase the radiation sensitivity of tumor. Nimotuzumab, a purely human EGFR monoclonal antibody, can significantly reduce the phosphorylation of the EGFR, has shown good anti-tumor activity in tumors of the head and neck, colorectal cancer and so on. It may be able to increase efficacy when combinate nimotuzumab with cisplatin concurrent radiotherapy for locally advanced cervical cancer.Purpose:The purpose of this study is to investigate the efficacy and toxiticy of cisplatin with or without nimotuzumab concurrent with radiotherapy in locally advanced cervical cancer. Method:20cases of locally advanced cervical cancer patients were recept randomly cisplatin combined with radiotherapy (control group) or cisplatin and nimotuzumab combined with radiotherapy (observation group). The volume of tumors were measured every two weeks by magnetic resonance imaging (MRI).The first point is the reduce rate of tumor, and the second point include adverse effect, overall survival, progression-free survival. EGFR expression was detected by immunohistochemistry (IHC), and EGFR mutations were detected by reverse transcription polymerase chain reaction(RT-PCR).Result:The reduce rate of tumor in patients who recept nimotuzumab with cisplatin concurrent radiotherapy is faster on the time of two weeks compared with control group(p=0.049), but no significant statistically difference was found on the time of four weeks, six weeks and eight weeks, respectively. The toxicity of hematological or non-hematological in two groups were similar.4years of PFS was58.3%in the observation group and the control group was33.3%(P=0.246).4years of OS was80%in the observation group and70%in control group, respectively(P=0.584). The expression rate of EGFR was25%, the mutation rate of EGFR was30%.Conclusion:Cisplatin with nimotuzumab concurrent radiotherapy in the treatment of locally advanced cervical cancer can improve the reduce rate of tumor compared with cisplatin concurrent radiotherapy. In this study, the expression rate of EGFR was25%. This study observed the presence of18-21exon mutation in patients with cervical cancer. The relationship between the expression and mutation of EGFR with the curative effects of nimotuzumab was not clear which was need for further observation.