We examined the benefits of the combination of anti-EGFR targeted treatment, cetuximab (CTX) or nimotuzumab (NTZ) and concurrent platinum-based chemoradiotherapy (CCRT) compared with CCRT alone in patients with stage II - IV_b nasopharyngeal carcinoma (NPC). A total of 1,628 eligible patients with stage II - IV_b NPC, who received CCRT (three cycles of 100 mg/m² cisplatin every 3 weeks with intensity-modulated radiotherapy) with or without CTX or NTZ between June 2009 and December 2013 were included in the analysis. Using propensity scores to adjust for potential prognostic factors, a well-balanced cohort of 878 patients was created by matching each patient who received CTX or NTZ plus CCRT with no more than four patients who received CCRT alone (1:4). Efficacy and safety were compared between CTX/NTZ plus CCRT and CCRT alone arms. Compared with CCRT alone, treatment with CTX/NTZ plus CCRT was associated with a significantly increased overall survival (3-year OS, 96.6% vs. 92.9%, P = 0.015), improved disease-free survival (3-year DFS, 93.5% vs 86.9%, P = 0.028), and improved distant metastasis-free survival (3-year DMFS, 94.6% vs 89.3%, P = 0.030). Increased rate of CTX related-skin reaction and mucositis was observed in the CTX plus CCRT arm. Multivariate analysis demonstrated the combination of CTX/NTZ was a significant protective factor for OS, DFS, and DMFS in patients treated with CCRT. Our analysis suggests that the addition of CTX/NTZ to CCRT is more effective for maximizing survival in patients with stage II-IVb NPC compared with CCRT alone.

中文翻译：

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Ⅱ期或Ⅳb期鼻咽癌同时放化疗联合或不联合抗EGFR靶向治疗：回顾性分析，队列大，随访时间长

我们研究了抗EGFR靶向治疗，西妥昔单抗（CTX）或尼莫妥珠单抗（NTZ）以及同时进行的铂类放化疗（CCRT）与II-IV _b期鼻咽癌（NPC）患者相比的优势。共有1,628名符合条件的II-IV _b NPC期患者接受了CCRT（三个周期100 mg / m ²分析包括2009年6月至2013年12月期间使用CTX或NTZ或不使用CTX或NTZ的每3周顺铂（使用强度调节放疗）。使用倾向评分来调整潜在的预后因素，通过将每位接受CTX或NTZ加CCRT的患者与不超过四位仅接受CCRT的患者进行匹配，创建了878位患者的均衡队列（1：4）。比较了CTX / NTZ加CCRT和CCRT单独治疗组的疗效和安全性。与单独使用CCRT相比，CTX / NTZ联合CCRT治疗可显着提高总生存期（3年OS，96.6％比92.9％，P = 0.015），改善无病生存期（3年DFS，93.5） ％vs. 86.9％，P = 0.028），并改善了远处无转移生存期（3年DMFS，94.6％vs 89.3％，P = 0.030）。在CTX加CCRT组中观察到CTX相关的皮肤反应和粘膜炎发生率增加。多变量分析表明，在接受CCRT治疗的患者中，CTX / NTZ的组合是OS，DFS和DMFS的重要保护因素。我们的分析表明，与单独使用CCRT相比，在CCRT中添加CTX / NTZ可使II-IVb期NPC患者的生存期最大化。