Clinical effect of targeted therapy with rituximab for patients with locally advanced nasopharyngeal carcinoma

doi:10.3760/cma.j.cn441417-20240727-04028

Abstract

Abstract:

Objective　To explore the clinical effect of targeted therapy with rituximab combined with nedaplatin chemotherapy and concurrent radiotherapy for patients with locally advanced nasopharyngeal carcinoma. Methods　Sixty-five patients with locally advanced nasopharyngeal carcinoma treated at Hanzhong Central Hospital and Ankang People's Hospital from August 2016 to December 2020 were selected for the randomized controlled trial, and were divided into a control group (33 cases) and an observation group (32 cases) by the random number table method. Three cases in the control group and 2 in the observation group lost to the follow up, with 30 cases in each group. There were 16 males and 14 females in the control group; they were (45.54±5.43) years old. There were 17 males and 13 females in the observation group; they were (46.02±5.47) years old. The control group took radiotherapy and nedaplatin chemotherapy. The observation group took radiotherapy, nedaplatin chemotherapy, and targeted treatment with nituzumab. The clinical efficacies, levels of biochemical indicators [white blood cell count (WBC), platelet count (PLT), and alanine transaminase (ALT)], serum epidermal growth factor like domain 7 (EGFL7), vascular endothelial growth factor (VEGF), and transforming growth factor β 1 (TGF - β 1) before the treatment and after 3 months' follow-up, adverse reactions during the follow-up period, recurrence rates, and survival status (3 years' follow-up) were compared between the two groups. χ² and t tests were used for the statistical analysis. Results　The total effective rate in the observation group was higher than that in the control group [70.0%(21/30) vs. 43.3%(13/30)], with a statistical difference (χ²=4.344; P=0.037). Before the treatment, there were no statistical differences in the levels of biochemical indicators and serum EGFL7, VEGF, and TGF-β1 between the two groups (all P>0.05). After 3 months' follow up, the levels of ALT, EGFL7, VEGF, and TGF-β1 in the observation group were lower than those in the control group [(44.65±6.54) U/L vs. (73.87±6.87) U/L, (48.65±7.54) μg/L vs. (60.98±1.98) μg/L, (188.65±18.54) ng/L vs. (209.09±27.65) ng/L, and (18.65±1.43) mg/L vs. (35.76±4.32) mg/L], with statistical differences (t=16.873, 8.663, 3.363, and 20.594; all P<0.05). During the follow up, the incidence rates of WBC decrease and nausea and vomiting in the observation group were lower than those in the control group [10.0% (3/30) vs. 63.3% (19/30) and 6.7% (2/30) vs. 30.0% (9/30)], with statistical differences (χ²=18.373 and 5.455; both P<0.05). There were no statistical differences in the recurrence rate and survival rate during the 3-year follow-up between the two groups (both P>0.05). Conclusion　Targeted therapy with rituximab combined with nedaplatin chemotherapy and concurrent radiotherapy for patients with locally advanced nasopharyngeal carcinoma can effectively regulate their serum levels of EGFL7, VEGF, and TGF-β1, control disease progress, improve treatment effect, and decrease the incidence of adverse reactions, and has minimal impact on their liver function.

Key words:

Nasopharyngeal carcinoma, Local late stage, Nidaplatin, Chemotherapy, Radiotherapy, Nistuzumab, Clinical efficacy

摘要：

目的　探讨尼妥珠单抗靶向治疗联合奈达铂化疗同步放疗对局部晚期鼻咽癌患者的临床效果。方法　选取2016年8月至2020年12月在汉中市中心医院、安康市人民医院接受治疗的65例局部晚期鼻咽癌患者进行随机对照试验，通过随机数字表法分为对照组（33例）和观察组（32例），其中对照组随访期间有3例失访，观察组有2例失访，最终两组各纳入30例。对照组男16例、女14例，年龄（45.54±5.43）岁，给予奈达铂化疗同步放疗治疗；观察组男17例、女13例，年龄（46.02±5.47）岁，在对照组基础上给予尼妥珠单抗靶向治疗。对比两组临床疗效、治疗前及随访3个月后的生化指标［白细胞计数（WBC）、血小板计数（PLT）、丙氨酸转氨酶（ALT）］、血清表皮生长因子样结构域7（EGFL7）、血管内皮生长因子（VEGF）、转化生长因子β1（TGF-β1）水平，以及不良反应（随访期间）、复发与生存情况（随访3年）。统计学方法采用t检验、χ²检验。结果　观察组治疗总有效率为70.0%（21/30），高于对照组的43.3%（13/30），差异有统计学意义（χ²=4.344，P=0.037）。治疗前，两组患者生化指标及血清EGFL7、VEGF、TGF-β1水平比较，差异均无统计学意义（均P>0.05）。随访3个月后，观察组ALT及血清EGFL7、VEGF、TGF-β1水平均低于对照组［（44.65±6.54）U/L比（73.87±6.87）U/L、（48.65±7.54）μg/L比（60.98±1.98）μg/L、（188.65±18.54）ng/L比（209.09±27.65）ng/L、（18.65±1.43）mg/L比（35.76±4.32）mg/L］，差异均有统计学意义（t=16.873、8.663、3.363、20.594，均P<0.05）。随访期间，观察组WBC下降、恶心呕吐发生率均低于对照组［10.0%（3/30）比63.3%（19/30）、6.7%（2/30）比30.0%（9/30）］，差异均有统计学意义（χ²=18.373、5.455，均P<0.05）。两组患者随访3年复发及生存情况比较，差异均无统计学意义（均P>0.05）。结论　局部晚期鼻咽癌患者经尼妥珠单抗靶向治疗联合奈达铂化疗同步放疗治疗，其血清EGFL7、VEGF、TGF-β1水平可得到有效调节，进一步控制病情进展，提高治疗效果，减少不良反应发生，且对肝功能影响较小。

关键词:

鼻咽癌, 局部晚期, 奈达铂, 化疗, 放疗, 尼妥珠单抗, 临床疗效

Zhang Yu, Zhang Kaishuo, Cao Hongyou, Gao Shan.

Clinical effect of targeted therapy with rituximab for patients with locally advanced nasopharyngeal carcinoma [J]. International Medicine and Health Guidance News, 2025, 31(4): 669-673.

张愉张恺铄曹洪友高山.

尼妥珠单抗靶向治疗局部晚期鼻咽癌患者的临床疗效观察 [J]. 国际医药卫生导报, 2025, 31(4): 669-673.

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