Effect of cetuximab combined with IMRT and concurrent chemotherapy in treating locally advanced nasopharyngeal carcinoma

Purpose: To explore the efficacy and safety of cetuximab combined with intensity-modulated radiotherapy (IMRT) and concurrent cisplatin-based chemotherapy in the treatment of patients with locally advanced nasopharyngeal carcinoma. Methods: The clinical information of 126 patients with locally advanced nasopharyngeal carcinoma, who were admitted to and treated in our department from September 2013 to May 2016, was collected, and they were randomly divided into two groups: cetuximab combined with IMRT and concurrent cisplatin-based chemotherapy group (Cetuximab group, n=63) and IMRT combined with concurrent cisplatin-based chemotherapy group (Control group, n=63). The clinical efficacy, changes in patients' quality of life and incidence of adverse reactions were observed and compared between the two groups, and the tumor progression and survival of the patients were followed up and recorded. Results: The patients in Cetuximab group exhibited substantially higher objective remission rate (ORR) and disease control rate (DCR) [90.5% (57/63) and 100%] than those in Control group [71.4% (46/63) and 88.9% (56/63)] (p=0.011 and 0.007). After treatment, the physiological status, social and familial status and emotional status based on the FACT-H&N scale were not statistically significantly different between the two groups of patients, but the patients in Cetuximab group had notably superior functional status, additional items for the head and neck and total scale score to those in Control group (p=0.011, 0.021 and 0.038). Additionally, the main adverse reactions of patient after treatment included myelosuppression, fever, gastrointestinal reactions, acne-like rash, radiodermatitis, oral mucositis, and liver and kidney function impairment, most of which were in grade I-II (p>0.05), and the differences between the two groups were not statistically significant (p>0.05). According to the log-rank test, the differences in the OS and PFS of patients between the two groups were not statistically significant (p=0.411 and 0.114). Conclusions: Cetuximab combined with IMRT and concurrent cisplatin-based chemotherapy has better clinical short-term efficacy in treating locally advanced nasopharyngeal carcinoma, and the patients treated have improved quality of life and can tolerate adverse reactions.