奥沙利铂、顺铂分别联合多西他赛用于局部晚期宫颈癌根治术前新辅助化疗的临床研究  

Neoadjuvant Chemotherapy of Oxaliplatin Plus Docetaxel and Cisplatin Plus Docetaxel before Radical Hysterectomy in Locally Advanced Cervical Cancer

作　　者：华诏召[1] 刘燕[1] 熊员焕[2] 

机构地区：[1]南昌大学研究生院医学部2008级,江西南昌330006 [2]江西省人民医院,江西南昌330006

出　　处：《实用妇产科杂志》2011年第12期908-911,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:比较奥沙利铂(OXA)联合多西他赛(DTX)与顺铂(DDP)联合DTX用于ⅠB2～ⅡB期局部晚期宫颈癌患者行根治性手术前新辅助化疗的疗效和毒副反应。方法:选择2009年2月至2010年12月江西省人民医院收治的ⅠB2～ⅡB期局部晚期宫颈癌患者65例,随机分为研究组(35例)和对照组(30例)。研究组采用OT方案(OXA130mg/m2+DTX75mg/m2);对照组采用PT方案(DDP60mg/m2+DTX75mg/m2),每组在根治性子宫切除术前各行新辅助化疗2个周期,并比较两组新辅助化疗的疗效、毒副反应及术后切除子宫标本的病理组织检查情况。结果:①研究组化疗的有效率(97.1%)与对照组(96.7%)比较,差异无统计学意义(P>0.05)。②新辅助化疗毒性反应:研究组WBC减少(Ⅱ度)发生率(5.7%)和N减少(Ⅱ度)发生率(15.7%)均低于对照组(18.3%和31.7%)(P<0.05);研究组脱发、恶心呕吐和肾脏毒性反应(Ⅰ度和Ⅱ度)发生率均明显低于对照组(P<0.05);研究组外周神经毒性反应率(Ⅰ度和Ⅱ度)(28.6%和20.0%)均明显高于对照组(6.7%和0)(P<0.05)。③两组术后标本病理组织检查:病理完全缓解率和理想的病理反应率及宫颈间质浸润、宫旁浸润、外科切缘阳性率等方面比较,差异均无统计学意义(P>0.05)。结论:OXA+DTX与DDP+DTX两种新辅助化疗方案对局部晚期宫颈癌均有明显效果,OXA+DTX方案总体毒性反应低于DDP+DTX方案,明显改善患者在化疗期间的生活质量。Objective：To compare the efficacy and toxicity of neoadjuvant chemotherapy of oxaliplatin（OXA） plus docetaxel（DTX） and cisplatin（DDP） plus docetaxel before radical hysterectomy in patients with stage ⅠB2～ⅡB locally advanced cervical cancer.Methods：From February 2009 to December 2010, 65 patients with stage ⅠB2～ⅡB locally advanced cervical cancer were enrolled in the study. The patients were randomly divided into experimental group （n=35） and control group （n=30）. The experimental group received oxaliplatin 130 mg/m2 plus docetaxel 75 mg/m2, while those patients in the control group were given the cisplatin 60 mg/m2 plus docetaxel 75 mg/m2. All of the patients in two groups were given two cycles of neoadjuvant chemotherapy. The efficacy, side effects of neoadjuvant chemotherapy and pathological examination after hysterectomy were compared in two groups.Results：①There was no significant difference in chemotherapy efficacy between the two groups（97.1% vs 96.7%, P0.05）.②The toxicity of neoadjuvant chemotherapy： the incidence of leucopenia （grade Ⅱ）, neutropenia （grade Ⅱ） in the experimental group were lower than those in control group （5.7% vs 18.3% and 15.7% vs 31.7%,P0.05）. However, the incidence of alopecia, nausea, vomiting and renal toxicity （grade Ⅰ,Ⅱ） in the experimental group were significantly lower than those in control group（P0.05）. And the incidence of peripheral nerve toxicity （grade Ⅰ,Ⅱ） in the experimental group were significantly higher than those in control group （28.6% vs 6.7% and 20.0% vs 0%, P0.05）.③There were no significant difference （P0.05） between two groups in pathological complete remission rate, ideal pathological response rate ,the cervical stromal invasion, parametrial invasion, positive rate of surgical margins etc（P0.05）.Conclusions：The neoadjuvant chemotherapy of both OXA plus DTX and DDP plus DTX have significant efficacy in the treatment of locally advanced cervical cancer, and the tox

关 键 词：奥沙利铂 顺铂 局部晚期宫颈癌 新辅助化疗 根治性子宫切除术 

分 类 号：R737.33[医药卫生—肿瘤]