Cetuximab联合放化疗治疗局部晚期鼻咽癌患者外周血VEGF的表达水平及疗效观察

摘要

目的:探讨Cetuximab联合放化疗治疗局部晚期鼻咽癌患者前后外周血中VEGF浓度的动态变化以及其与临床疗效之间的关系.方法:21例初诊为鼻咽癌的局部晚期患者进行随机分组,其中对照组10例,治疗组11例,分别采用同步放化疗及同步放化疗联合Cetuximab靶向治疗.治疗组患者分别于第一次靶向治疗前1天、治疗后第1天、第9天、第35天和第56天采集血清,对照组患者于治疗前1天与治疗结束时采集血清.采用酶联免疫吸附法(ELISA)测定血清中VEGF水平.结果:治疗组与对照组患者血清中VEGF水平均显著下降,下降百分比均数分别为(31.50±12.11)%和(20.20±3.55)%,差异具有统计学意义(P=0.019);治疗组患者血清中VEGF水平首次治疗后持续下降,治疗结束时下降程度达到最大,总体下降百分比均数为31.46%;治疗结束时,联合治疗组患者VEGF水平下降更为显著,同时达到CR比率更高(72.73% vs 50%,P＜0.05);联合治疗组患者中VEGF水平下降显著者,临床疗效较好.结论:Cetuximab联合放化疗后,局部晚期鼻咽癌患者血清VEGF水平明显下降;下降明显者,临床疗效好;VEGF水平下降可以作为Cetuximab疗效的预测指标.%Objective: To investigate the dynamic changes of VEGF in peripheral blood of locally advanced nasopharyngeal carcinoma patients before and after the treatment of Cetuximah combined with chemoradiotherapy and its correlation with clinical effects. Methods: 21 cases of newly diagnosed patients with locally advanced nasopharyngeal carcinoma were randomized into two groups. 10 cases in the control group were treated with concurrent chemoradiotherapy. And 11 cases in the treatment group were treated with concurrent chemoradiotherapy combined with Cetuximah targeted therapy. Serum of patients in the treatment group were collected on one day hefore the first targeted therapy, d1 , d9 , d35 and d56 after treatment. And serum of the control group were collected one day before and at the end of the treatment. Serum VEGF levels were detected by enzyme- linked immunosorbent assay ( ELISA ). Results : Serum VEGF levels in both groups were signific:antly decreased [ ( 31. 50 ± 12. 11 )％ and ( 20. 20 ±3. 55 )％ respectively, P =0. 019 ]. Serum VECF levels in the treatment group continued to decline after the initial treatment and reached the maximum span of decline in the end of treatment. The mean percentage of the overall decline was 31. 46％ . At the end of the treatment. the VEGF levels of the combined treatment group dropped more significantly as well as reached a higher CR rate ( 72. 73％ vs 50％ , P ＜ 0. 05 ). Patients in combined treatment group whose VEGF levels decreased more significantly got hetter clinical outcomes. Conclusion: After Cetuximab treatment. VEGF levels in patients with locally advanced nasopharyngeal carcinoma declined significantly. The one whose VEGF levell dropped more significantly got better clinical efficacy. It is snggested that VEGF decline levels can serve as a predictor of efficacy of Cetuximab.