2016 年第 1 期 第 14 卷

尼妥珠单抗治疗晚期肺鳞癌的临床观察

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关键词：尼妥珠单抗肺鳞状细胞癌

• 摘要：
• 【摘要】目的 观察尼妥珠单抗治疗晚期肺鳞癌的临床疗效和安全性。方法 回顾性分析2012年2月至2015年4月在北京协和医院呼吸科使用尼妥珠单抗治疗的肺鳞癌患者的临床资料，进行疗效和安全性评估。所有患者都签署了知情同意书，并同意提供临床资料。结果 共有12例患者入组研究。3例ⅢB期患者，其中2例一线使用尼妥珠单抗联合放化同步治疗，病情进展（PD）；1例二线使用尼妥珠单抗联合化疗，病情稳定（SD），无进展生存12.0月。9例Ⅳ期患者，7例一线使用尼妥珠单抗联合化疗，PR 4例，SD 3例，客观有效率（ORR）57.1%，疾病控制率（DCR）100%；2例二线使用尼妥珠单抗联合化疗，均为SD。毒副反应包括中性粒细胞减少7例（58.3%），血小板减少3例（25.0%），呕吐1例（8.3%），乏力3例（25.0%），神经毒性5例（41.7%），脱发10例（83.3%）。毒副反应多与联合使用的化疗药物相关。结论 尼妥珠单抗联合化疗治疗晚期肺鳞癌客观有效率、疾病控制率高，不良反应可控制。
• Objective To evaluate efficacy and safety of nimotuzumab for advanced lung squamous cell carcinoma. Methods A retrospective analysis of clinical data was conducted in patients with advanced lung squamous cell carcinoma, who were treated by nimotuzumab during February 2012 to April 2015 in Department of Respiratory Medicine, Peking Union Medical College Hospital. All patients signed the informed consents, and consented to offer clinical information. Results 12 patients were enrolled in this study. Among three patients of stage ⅢB lung cancer, 2 patients were treated by nimotuzumab combined with concurrent chemoradiation as first line treatment, but diseases progressed in both patients; one patient treated by nimotuzumab with chemotherapy as second line treatment had stable disease (SD) and 12 months of progression-free survival (PFS). Among 9 patients with Stage Ⅳ lung cancer, 7 cases were treated by nimotuzumab and chemotherapy as first line treatment, with 4 cases of partial remission (PR) and 3 cases of SD. Objective response rate of these seven patients is 57.1%, and disease control rate is 100%; two patients treated by nimotuzumab with chemotherapy as second line treatment had SD. Among these 12 cases, the adverse effects were manageable, including 7 cases (58.3%) of neutropenia, 3 cases (25.0%) of thrombocytopenia, 1 case (8.3%) of nausea, 3 cases (25.0%) of fatigue, 5 cases (41.7%) of peripheral sensory neuropathy, 10 cases (83.3%) of alopecia. All adverse effects were attributed to chemotherapy. Conclusion Objective response rate and disease control rate of nimotuzumab combined with chemotherapy is high in patients with advanced lung squamous carcinoma, and adverse effects are manageable.