| Objective: To explore the effect of nimotuzumab combined with albuminbound paclitaxel-cisplatin-S-1 on local control rate,distant metastasis rate and survival rate of advanced Oral squamous cell carcinoma(OSCC),and to provide evidence for the treatment of advanced oral cancer.Methods: From March 2018 to December 2019,the case data of 90 patients with stage Ⅲ-Ⅳ oral squamous cell carcinoma who were hospitalized in the Fourth Hospital of Hebei Medical University and diagnosed by pathology were analyzed and divided into two groups according to different preoperative treatment methods.Among them,30 cases were treated with nimotuzumab combined with albumin-bound paclitaxel-cisplatin-s-1 before operation(N+APS group),and the primary focus was cured after 2 cycles;60cases underwent radical operation of primary focus directly(group S);Chemotherapy and radiotherapy were added to patients with adverse characteristics after operation.The median survival time of patients was defined as the median follow-up time.The median follow-up time was 27.50 months.The follow-up rate was 97.8%.The main observation endpoints were Overall Survival(OS)and Disease free survival(DFS),and the secondary observation endpoints were Local control rate(LCR)and Distant metastasis rate(DMR).All data were analyzed by SPSS26.0 statistical software.Frequency is used to represent counting data,Chi-square test is used to analyze disordered counting data,and nonparametric rank sum test is used to analyze grade data.Kaplan-Meier method was used to draw the survival curve of patients with advanced oral squamous cell carcinoma and screen the factors that may affect the prognosis.Multivariate Cox proportional hazard model was used to analyze the independent factors that affect the prognosis.P < 0.05,the difference was statistically significant.Results:1.The 2-year OS of patients in N+APS group and S group were 83.33%and 68.33%,respectively,with no significant difference(P < 0.05).2.The 2-year DFS of patients in N+APS group and S group were 78.97%and 51.67%,respectively,and the difference was statistically significant(P <0.05).3.The local recurrence rates of patients in N+APS group and S group were 10.00% and 28.33% respectively,and the difference was statistically significant(P < 0.05).The distant metastasis rates were 10.00% and 13.33%,respectively,with no significant difference(P>0.05).4.Kaplan-Meier survival curve showed that N+APS group had better OS and DFS than S group in patients with advanced OSCC.Univariate analysis showed that treatment methods(grouping)(P=0.028),tumor recurrence(P<0.001),lymph node metastasis(P=0.001)and postoperative radiotherapy(P=0.016).5.Multivariate Cox proportional hazards regression analysis showed that the treatment methods(grouping)(HR=1.665,95% CI: 1.093-2.538),tumor recurrence(HR=5.207,95% CI: 2.219-12.217),lymph node metastasis(HR=5.309,95% 95% CI: 0.151-0.797)is an independent factor affecting the prognosis of patients with advanced OSCC.Compared with N+APS group,the risk of death in S group is increased(HR=1.665,P< 0.05).Conclusions:1.Nimotuzumab combined with APS chemotherapy can improve the disease-free survival time of patients with advanced OSCC,and prolong the median survival time of patients,but it has no obvious advantage on the overall survival rate.2.Nimotuzumab combined with APS chemotherapy can reduce the local recurrence rate of patients with advanced OSCC,and make patients with advanced OSCC have better local control,but it has no obvious advantage in improving distant metastasis rate.3.Treatment methods(grouping),tumor recurrence,lymph node metastasis and postoperative radiotherapy are independent factors affecting the prognosis of patients with advanced OSCC.4.Patients with advanced OSCC who have lymph node metastasis,tumor recurrence and do not receive radiotherapy after operation have poor prognosis,but EGFR monoclonal antibody combined with chemotherapy before operation can benefit patients’ survival. |
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