本文選題：表皮生長因子受體　切入點(diǎn)：宮頸癌　出處：《浙江大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：宮頸癌是女性第二大常見惡性腫瘤,也是女性主要的死亡原因。含鉑方案的同步放化療是局部晚期宮頸癌的標(biāo)準(zhǔn)治療,但治療后大多數(shù)患者為部分緩解或緩解時(shí)間較短,超過35%的患者腫瘤持續(xù)存在、復(fù)發(fā)或轉(zhuǎn)移,需要尋找一些新的藥物或方法來提高療效。研究發(fā)現(xiàn),宮頸癌中存在表皮生長因子受體(EGFR)過度表達(dá),與腫瘤對細(xì)胞毒藥物及放療抵抗有關(guān)。體內(nèi)、外研究均發(fā)現(xiàn),阻斷EGFR可增加腫瘤的放療敏感性。尼妥珠單抗是一種純?nèi)嗽椿腅GFR單克隆抗體,可以明顯降低EGFR的磷酸化,在頭頸部、結(jié)直腸癌等腫瘤中已經(jīng)顯示了較好的抗腫瘤活性。因此聯(lián)合順鉑同步放化療治療局部晚期宮頸癌可能可以增加療效。 目的：本研究旨在比較觀察順鉑加或不加尼妥珠單抗同步放化療治療局部晚期宮頸癌的療效及毒副作用。 方法：20例局部晚期宮頸癌患者隨機(jī)接受順鉑同步放化療(對照組)或者尼妥珠單抗聯(lián)合順鉑同步放化療(觀察組),每兩周采用MRI測量腫瘤體積,主要觀察終點(diǎn)為腫瘤退縮速度,次要觀察終點(diǎn)為毒副反應(yīng)評價(jià)及生存率(OS)和無進(jìn)展生存率(PFS)。采用免疫組化法檢測宮頸癌EGFR表達(dá)、RT-PCR檢測EGFR突變情況。 結(jié)果：尼妥珠單抗聯(lián)合順鉑同步放化療在治療2周時(shí)腫瘤退縮明顯更快(P0.049),而4周(P=0.063)、6周(P=0.15)、8周(P=0.234)時(shí)無明顯差異；血液學(xué)和非血液學(xué)毒性兩組相似。4年P(guān)FS觀察組為58.3%,對照組為33.3%(P=0.246),4年OS觀察組80%,對照組為70%(P=0.584)。EGFR表達(dá)率為25%,EGFR突變率為30%。 結(jié)論：尼妥珠單抗聯(lián)合順鉑同步放化療治療局部晚期宮頸癌可以加快腫瘤早期退縮速度,提高療效,安全性好。本研究EGFR表達(dá)率為25%,EGFR存在18-21外顯子突變,但兩者與尼妥珠單抗療效是否相關(guān)尚不清楚,需要進(jìn)一步觀察。
[Abstract]:Cervical cancer is the second most common malignant tumor in women and the leading cause of death in women. Chemotherapy and radiotherapy with platinum regimen is the standard treatment for locally advanced cervical cancer. More than 35% patients have tumors that persist, recur or metastasize, and new drugs or methods need to be found to improve their efficacy. Studies have found that epidermal growth factor receptor (EGFR) overexpression is present in cervical cancer. In vivo and in vitro, blocking EGFR can increase the radiosensitivity of tumor. Nitozumab is a pure human monoclonal antibody to EGFR, which can significantly reduce the phosphorylation of EGFR. In the head and neck, colorectal cancer and other tumors have shown good anti-tumor activity, so the combination of cisplatin combined with radiotherapy and chemotherapy may be able to increase the efficacy of locally advanced cervical cancer. Objective: to compare the efficacy and side effects of cisplatin plus or no niytozumab in the treatment of locally advanced cervical cancer. Methods Twenty patients with locally advanced cervical cancer were randomly given cisplatin concurrent radiotherapy and chemotherapy (control group) or Nietozumab combined with cisplatin concurrent chemotherapy (observation group). Tumor volume was measured by MRI every two weeks. The main endpoints were tumor withdrawal rate, and the end points were toxicity evaluation and survival rate (OS) and progressive survival rate (PFS). Immunohistochemical method was used to detect EGFR expression in cervical cancer and RT-PCR was used to detect EGFR mutation. Results: Nietozumab combined with cisplatin concurrent radiotherapy and chemotherapy had no significant difference at 2 weeks after treatment with P0. 049, but 4 weeks with P0. 063 and 6 weeks with P0. 15 and P0. 234. The toxicity of hematology and non-hematology was similar between the two groups: 58.3in the PFS observation group in 4 years, 0.246 in the control group, 80in the OS observation group for 4 years, and in the control group, the expression rate of 0.584o.EGFR in the control group was 250.584. the mutation rate of EGFR was 30. Conclusion: Niytozumab combined with cisplatin concurrent radiotherapy and chemotherapy can accelerate the early withdrawal rate of local advanced cervical cancer, improve the efficacy and safety. The expression rate of EGFR in this study is 25% EGFR exon 18-21 mutation. However, it is not clear whether the two are related to the efficacy of Nitozumab, and need further observation.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R734.2

【參考文獻(xiàn)】

相關(guān)期刊論文 前2條

1 王利娟;田園;高積勇;;宮頸癌預(yù)后與表皮生長因子受體蛋白表達(dá)關(guān)系[J];中國婦幼健康研究;2006年04期

2 劉俊麗;陳元;蔡煜;;表皮生長因子受體酪氨酸激酶抑制劑ZD1839對宮頸癌細(xì)胞的作用[J];腫瘤防治研究;2006年07期

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本文編號：1573466