Clinical effectiveness of 125I-seed implantation in combination with nimotuzumab therapy for the advanced oral carcinoma: preliminary results

Abstract

Objective: This study determines the short-term efficacy and toxicity of combined 125I-seed implantation and nimotuzumab in treating the advanced oral carcinoma. 125I-seed implantation is safe and has shown good short-term efficacy in clinical practice. Nimotuzumab is a useful biological agent for targeted therapy. Effect of 125I-seed implantation with nimotuzumab in treating oral carcinomas remains unclear.

Patients and methods: From November 2011 to December 2012, 11 patients with advanced oral carcinoma (pathologic types: 7 cases of squamous cell carcinoma and 4 cases of poorly differentiated adenocarcinoma) were enrolled in our hospital. The patients did not receive surgery due to systemic disease or locally advanced cancer. All of them underwent 125I-seed implantation with the matched peripheral doses (MPD) ranging from 90-100 Gy. The apparent activity per seed ranged from 0.6 mCi (2.22 MBq) to 0.7 mCi (2.59 MBq). Later, all patients were given nimotuzumab (200 mg, intravenous drip, weekly, for 6 weeks). The patients were then followed up and the response rate, acute/chronic radiation-induced injury, and safety of the induction treatment were analyzed.

Results: Three patients achieved complete while 6 patients had partial response; yielding a response rate of 81.8%. Major adverse events included radiation-induced oral mucositis, local hemorrhage, bone marrow suppression, nausea/vomiting, and alopecia. Adverse reaction was not significantly different between the group of patients under 65 years of age and over 65 years of age (p > 0.05). Nimotuzumab enhanced the tumor sensitivity to brachytherapy without increasing AEs and improved the patients' life quality.

Conclusions: 125I-seed implantation combined with nimotuzumab is effective and safe for patients with unresectable oral carcinoma.