Clinical Efficacy Of Cetuximab Combined With Induction Chemotherapy Plus Concurrent Chemoradiotherapy For Locally Advanced Nasopharyngeal Carcinoma

Objective:To compare the efficacy and adverse reactions of induction chemotherapy(IC)plus cetuximab(CTX)or not plus concurrent chemoradiotherapy in patients with locally advanced nasopharyngeal carcinoma,we evaluated the necessity of adding cetuximab during induction chemotherapy.Methods : From January 2014 to August 2016,26 patients with nasopharyngeal carcinoma of III-IVb stage who received cetuximab combined with induction chemotherapy plus concurrent chemoradiotherapy at the Affiliated Tumor Hospital of Guangxi Medical University were assigned to investigational group.In the same period,212 nasopharyngeal carcinoma patients in III-IVb stage who treated with only induction chemotherapy plus concurrent chemoradiotherapy,26 patients were assigned to control group were matched 1:1 with the investigational group.The Kaplan-Meier method was used to calculate the survival rates and log-rank method was used to test the difference,other comparison was perfomed by ? 2-test ?rank sum test and t-test.Results:The median follow-up period was 34 months(20 to 49 months),and the follow-up rate was 100%.The three-year OS,DMFS,and LRFS in the investigational group vs.the control group were 91.0%vs.82.8%(P=0.468),89.1%vs.69.9%(P=0.344),and 100%vs.95.5%(P=0.420)respectively.The percentage of GTVnx that was reduced before induction chemotherapy compared with after induction chemotherapy in investigational group was 37.83±12.14 %,and 27.85±12.01 % in the control group,There was a statistically significant difference between the two groups(P=0.004).There was no statistically significant difference in the oral mucosal response,upper gastrointestinal reaction,liver and kidney function impairment,and hematological adverse reaction between the two groups during the entire treatment period.Conclusion:The preliminary results suggest that the use of cetuximab combined with induction chemotherapy for the treatment of patients with locally advanced nasopharyngeal carcinoma,the efficacy of three-year OS,DMFS,LRFS is not clear,the toxicity can be tolerated.However,cetuximab combined with induction chemotherapy can further reduce the tumor volume.