Analysis of the efficacy and safety of nimotuzumab combined with induction chemotherapy for patients with locally advanced head and neck squamous cell carcinoma
Objective To explore the efficacy and adverse reactions of nimotuzumab combined with induction chemotherapy(IC)based on albumin-bound paclitaxel plus cisplatin(TP regimen)for patients with locally advanced head and neck squamous cell carcinoma(LA-HNSCC).Methods Clinical data were collected from 65 patients with LA-HNSCC(stages Ⅲ/ⅣA/ⅣB;excluding nasopharyngeal carcinoma)who received 2-3 cycles of IC followed by concurrent chemoradiotherapy(CRT)in the Second Hospital of Dalian Medical University from January 2018 to June 2022.Based on the IC regimen,these patients were categorized into a nimotuzumab combined with TP(Nimo-TP)group(n=34)and a TP group(n=31),and their short-term efficacy[i.e.,the objective response rate(ORR)],survival outcomes[e.g.,overall survival(OS),progression-free survival(PFS),local recurrence-free survival(LRFS),and distant metastasis-free survival(DMFS)],and adverse reactions were compared.Additionally,factors affecting their survival outcomes were analyzed.Results There were statistically significant differences in 1-and 2-year DMFS between both groups(90.4％vs.69.5％,90.4％vs.66.0％,x2=1.81,P＜0.05),so did the ORRs after IC and CRT of both groups(after IC:67.6％vs.41.9％,x2=4.34,P=0.037;after CRT:88.2％vs.67.7％,x2=4.03,P=0.045).However,there was no statistically significant difference in the 2-year OS,PFS,and LRFS between both groups(P＞0.05).Multivariate analysis revealed that nimotuzumab combined with TP-based IC served as an independent prognostic factor for DMFS(HR=0.27,95％CI:0.07-0.97,P=0.045),while complete/partial response after IC acted as an independent prognostic factor for both PFS and local relapse-free survival(HR=0.36,95％CI:0.17-0.76,P=0.008;HR=0.28,95％CI:0.11-0.69,P=0.006).Notably,adding nimotuzumab did not aggravate the adverse reactions in the patients during IC and CRT(P＞0.05).Conclusions Nimotuzumab combined with TP-based induction chemotherapy followed by CRT significantly improved the DMFS of LA-HNSCC patients,exhibiting high safety.However,such therapy failed to significantly improve their OS,PFS,and LRRFS,and,thus,further research is required.
NimotuzumabEGFRHead and neck squamous cell carcinomaInduction chemotherapyConcurrent chemoradiotherapy
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