The Research Of Effect And Toxicity Between Concurrent Chemoradiotherapy And Nimotuzumd Concurrent Radiotherapy For Locally Advanced Nasopharyngeal Carcinoma

Objective:Comparison of long-term effect and toxicity of concurrent chemoradiotherapy(CRT)and Nimotuzumab concurrent radiotherapy(NRT)for locally advanced nasopharyngeal carcinoma.Methods:64 patients with locally advanced nasopharyngeal carcinoma with initial treatment in Oncology department of our hosptial,from January 2010 to December2012.36 patients received cisplatin plus radiotherapy(CRT)and 28 received Nimotuzumab plus radiotherapy(NRT).All of patients received DP induction chemotherapy:docetaxel 75 mg / m2 d1,cisplatin 35 mg / m2 d1-2,every 3 weeks as a course of treatment.After 2 courses of induction chemotherapy,2-3 weeks later received radical radiotherapy.IMRT was applied to all patients,with one time a day,five times per week.CRT group : cisplatin 40mg/m2/QW/6w concurrent with radiotherapy.NRT group: Nimotuzumab 200mg/QW/6w concurrent with radiotherapy.prescription dose of irradiation PGTV-nx:66-70GY/30F;PGTV-nd:60-70GY/30F;High risk clinical target(PCTV-60): 60Gy/30F;Low-risk clinical target(PCTV-54):54Gy/30 F.Results:In term of effects:3-year Over survival rate CRT group was 83.3%,NRT group was 82.1%,P=0.868,there was no statistical significance;CRT group 3-year Progress free survival rate was 77.8%,NRT group 3-year Progress free survival rate was75.0%,P=0.819,there was no statistical significance;CRT group 3-year Locoregional failure free survival rate was 91.7%,N-RT group 3-year Locoregional failure free survival rate was 89.3%,P=0.760,there was no statistical significance.CRT group3-year Distant metastasis free survival was 86.1%,NRT group 3-year Distant failure free survival was 85.7%,P=0.947,there was no statistical significance.Acute toxicity:III / IV grade leukopenia CRT group was 38.9%,NRT group was 14.3%,P=0.030,there was statistical significance;III / IV grade neutropenia CRT group was 33.3%,NRT was 10.7%,P=0.034,there was statistical significance;Thrombocytopenia occurred in CRT group was 5.6%,NRT group was 10.7%,P=0.646,there was no statistical significance;III / IV grade anemia CRT group was 16.7%,NRT group was0,P=0.031,there was statistical significance.;The I / II grade vomiting reaction of CRT group was 50%,NRT group was 25%,P =0.042,there was statistical significance.;The III / IV grade vomiting reaction CRT group was 27.8%,NRT group was 0,P =0.003,there was statistical significance.Acute toxicity cased by radiation:I / II grade skin reaction rate CRT group was 36.1%,NRT group was 39.3%,P=0.795,there was no statiscal significance;III / IV grade skin reaction rate CRT group was25.0%,NRT group was 25%,P=1.000,there was no statistical significance;I / II grade oral mucositis CRT group was 38.9%,NRT group was 42.9%,P=0.621,there was no statistical significance;III / IV grade oral mucositis CRT group was 33.3%,NRT group was 28.6%,P=0.683,there was no statistical significance.Late toxicity cased by radiation: The I-IV grade Radiation myelopathy both groups did not appeared;I / II grade encephalopathy radiation damage CRT group was5.6%,NRT group was 3.6%,P=0.709,there was no statistical significance;The III / IV grade both groups did not appeared;The I / II grade radiation tissue fibrosis CRT group was 8.3%,NRT group was 3.6%,P=0.435,there was no statistical significance;The III / IV grade both groups did not appeared;I / II grade salivary gland damage CRT group was 77.8%,NRT group was 82.1%,P=0.667,there was no statistical significance;The III / IV grade both groups did not appeared.I / II grade ear damage CRT group was 22.2%,NRT group was 21.4%,P=0.939,there was no statistical significance;The III / IV grade both groups did not appeared.Conclusion:For locally advanced nasopharyngeal carcinoma patients,the long-term effects of CRT group and NRT group were similar.In terms of toxicity: III / IV grade leukopenia,III / IV grade neutropenia,III / IV grade anemia,I-IV grade vomiting reaction CRT group were significantly higer than NRTgroup,there were statistical significance.Radiation related acute toxicity and late toxicity there were no statistical significance.