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目的评价西妥昔单抗联合术后同步放化疗治疗晚期复发性喉癌及下咽癌患者的近期疗效和不良反应。方法晚期复发性头颈癌患者6例,其中喉复发癌2例,下咽复发癌1例,下咽癌伴肺转移1例,气管造瘘口复发癌2例。分别予以手术治疗后3周,西妥昔单抗与同步放化疗,用法:西妥昔单抗第1周初始剂量为400mg/m2,以后每周维持剂量为250mg/m2,共3周。所有患者均采用直线加速器放疗,常规分割调强放疗,总剂量60Gy,6周完成。在放疗的同时给予化疗,方案是:DDP80mg/m2/d1,5-Fu800mg/m2,120h持续化疗泵静滴。化疗1次/3周,共3次。结果所有患者均顺利完成治疗计划。西妥昔单抗主要不良反应为皮疹、口腔炎、疲乏等。中位随访10个月,病例均存活且肿瘤无进展,未发生远处转移。结论西妥昔单抗联合术后同步放化疗治疗晚期复发性头颈癌安全有效,治疗计划顺利进行,尚需进行进一步临床试验研究。
Objective To evaluate the short-term efficacy and adverse reactions of cetuximab combined with concurrent radiotherapy and chemotherapy in patients with advanced recurrent laryngeal and hypopharyngeal cancer. Methods There were 6 patients with advanced recurrent head and neck cancer, including 2 cases of recurrent laryngeal cancer, 1 case of recurrent hypopharyngeal carcinoma, 1 case of hypopharyngeal carcinoma with lung metastasis, and 2 cases of tracheal fistula recurrence. Three weeks after surgery, cetuximab and concurrent chemoradiotherapy were used. The first dose of cetuximab was 400 mg/m 2 in the first week, and the weekly maintenance dose was 250 mg/m 2 for 3 weeks. All patients were treated with linear accelerator radiotherapy, conventional segmented intensity modulated radiation therapy, with a total dose of 60 Gy, completed in 6 weeks. The chemotherapy was given at the same time as radiotherapy. The protocol was: DDP 80 mg/m2/d1, 5-Fu 800 mg/m2, 120 h continuous chemotherapy pump intravenous drip. Chemotherapy 1/3 weeks for 3 times. Results All patients successfully completed the treatment plan. The main adverse effects of cetuximab were rash, stomatitis, and fatigue. After a median follow-up of 10 months, all cases survived and the tumors did not progress. No distant metastases occurred. Conclusion Cetuximab combined with concurrent chemoradiotherapy for the treatment of advanced recurrent head and neck cancer is safe and effective. The treatment plan goes smoothly. Further clinical trials are needed.