The Clinical Efficacy And Pathological Effects Of EGFR Monoclonal Antibody Combined With Induction Chemotherapy On Locally Advanced Oral Squamous Cell Carcinoma

Objective: To explore the clinical efficacy and pathological effects of anti-EGFR monoclonal antibody Nimotuzumab injection(N)combined with Albumin-bound paclitaxel,cisplatin,and tegafur(s-1)(APS)preoperative induction chemotherapy on locally advanced oral squamous cell carcinoma.Methods: A retrospective collection of 83 patients with locally advanced oral squamous cell carcinoma who were diagnosed and treated in the Oral and Maxillofacial Surgery Department of the Fourth Hospital of Hebei Medical University from September 2019 to December 2020 were the research objects.The cohorts were divided into anti-EGFR monoclonal antibodies combined with induction chemotherapy(N+APS)group and APS chemotherapy group,all patients underwent radical surgery after medication.The efficacy evaluation criteria for solid tumors(RECIST)were used to analyze the clinical efficacy and T-falling status of the two groups of patients after medication,and the tumor regression grade(TRG)scoring standard was used to evaluate the morphological changes of tumors after medication.analyze the clinicopathological characteristics that affect tumor regression grade(TRG)and the correlation between TRG grade and response evaluation criteria in solid tumor(RECIST).Results:1.According to the RECIST1.1 evaluation standard,the effective rate after treatment in the N+APS group was 77.14%(27/35),and the effective rate in the APS group was 54.17%(26/48).There was a statistically significant difference in the effective rate between the two groups(P <0.05).2.Refer to the modified version of Ryan "0-3" four-level system to evaluate tumor morphology changes after medication.The results showed that in the N+APS group,TRG0: 6 cases(17.14%),TRG1: 14 cases(40%),TRG2level: 11 cases(31.43%),TRG3 level: 4 cases(11.43%);in the APS group,TRG0 level: 4 cases(8.33%),TRG1 level: 15 cases(31.25%),TRG2 level: 20cases(41.67%),TRG3 grade: 9 cases(18.75%).Comparison of the difference in the degree of tumor regression between the two groups,the incidence of good tumor regression(TRG0+1)in the N+APS group was 57.14%(20/35),and the incidence of patients without significant tumor regression(TRG2+3)was 42.86%(15)/35),the incidence of patients with good tumor regression(TRG0+1)in the APS group was 39.58%(19/48),and the incidence of patients with no significant tumor regression(TRG2+3)was 60.42%(29/48),The difference between the two groups was not statistically significant(P>0.05).3.Among the 83 patients,56 cases had T-fall,of which 28 were in the N+APS group,28 were in the APS group,80% of the N+APS group had T-fall,and 2.86% had tumor progression;58.33% of the APS group had T-fall,6.25 % Tumor progressed,and the incidence of T downstage in the two groups was statistically significant(P<0.05).4.Univariate analysis showed that tumor size,clinical T staging,and degree of differentiation are predictive factors that affect TRG after preoperative adjuvant therapy for locally advanced oral squamous cell carcinoma.Logistic multivariate analysis showed that tumor size,clinical T stage,and degree of differentiation were independent influencing factors of TRG grade after medication.5.Correlation analysis between tumor regression grade(TRG)and solid tumor curative effect(RECIST)shows that TRG grade is correlated with RECIST1.1 standard,and TRG grade predicts RECIST1.1 standard to evaluate the efficacy of medication(grade 0-1 corresponds to CR/PR),Grade2-3 corresponds to PD/SD)with a sensitivity of 93.33% and a specificity of69.81%,suggesting that the TRG classification can be used as a method for evaluating the efficacy of locally advanced oral squamous cell carcinoma.Conclusions:1.For locally advanced oral squamous cell carcinoma,the clinical and pathological effectiveness of Nimotuzumab injection(N)combined with Albumin-bound paclitaxel,cisplatin,and tegafur(s-1)(APS)preoperative induction chemotherapy are better than APS Chemotherapy.2.Nimotuzumab injection(N)combined with Albumin-bound paclitaxel,cisplatin,and tegafur(s-1)(APS)preoperative induction chemotherapy regimens have a higher incidence of T-downstage than APS chemotherapy regimens.3.Tumor size,clinical T stage and degree of differentiation are independent influencing factors of TRG grade after treatment of locally advanced oral squamous cell carcinoma.4.There is a correlation between the TRG classification and the RECIST1.1 standard,and the TRG classification can be used as a reference index for evaluating the efficacy of locally advanced oral squamous cell carcinoma.