不同剂量顺铂周化疗治疗ⅡB期～ⅣA期宫颈癌的疗效评价  

Evaluation on efficacy of different doses of weekly cisplatin chemotherapy in treatment of stage ⅡB-ⅣA cervical cancer

作　　者：王福香[1] 朴金霞[1] 苏清秀[1] 张矛[1] 

机构地区：[1]吉林省肿瘤医院放疗三科,吉林长春130012

出　　处：《吉林大学学报（医学版）》2013年第2期352-356,共5页Journal of Jilin University：Medicine Edition

基　　金：中国民政部"十一五"期间部级老年学项目资助课题(200718219)

摘　　要：目的:观察放疗联合不同剂量顺铂周疗方案治疗中晚期宫颈癌的治疗效果,探寻宫颈癌最佳的治疗方案。方法:收集2007年1月—2008年6月本院收治的符合入组标准的ⅡB～ⅣA期宫颈癌患者135例,按住院序号随机分为单纯放疗45例(单纯放疗组);同步放化疗90例(同步放化疗组),其中顺铂周疗20mg.m-2低剂量组45例及40mg.m-2标准剂量组45例。比较单纯放疗组与同步放化疗组患者的3年生存率及相关毒性反应发生率。同时对同步放化疗组中的2种不同剂量顺铂周疗方案组患者的3年生存率及相关毒性反应发生率进行比较。结果:全组中位随访时间42(6～51)个月。单纯放疗组患者与同步放化疗组患者3年生存率分别是68.9%和83.3%,2组比较差异有统计学意义(χ2=3.858,P<0.05)。单纯放疗组Ⅲ-Ⅳ级急性毒性反应发生率低于同步放化疗组(χ2=4.072,P<0.05)。同步放化疗组中,20mg.m-2低剂量组及40mg.m-2标准剂量组患者的3年生存率分别为82.2%和84.4%,2组比较差异无统计学意义(χ2=0.090,P>0.05)。20mg.m-2低剂量组急性毒性反应发生率明显低于40mg.m-2标准剂量组患者(χ2=3.920,P<0.05)。结论:与单纯放疗比较,同步放化疗可明显提高ⅡB期～ⅣA期宫颈癌的疗效。在同步放化疗中,与40mg.m-2标准剂量顺铂比较,20mg.m-2低剂量顺铂可以在不降低患者疗效的同时,降低患者Ⅲ-Ⅳ级急性毒性反应的发生率。Objective To observe the curative effect of different doses of radiotherapy combined with cisplatin weekly therapy in the treatment of advanced cervical cancer,and to explore better treatment options.Methods 135 cases of stage ⅡB-ⅣA cervical cancer patients collected in Jilin Provincal Tumor Hospital from January 2007 to June 2008 met the inclusion criteria were randomly divided into radiotherapy group（n=45,radiotherapy alone） and concurrent chemoradiotherapy group（n=90）,including 20 mg·m-2 low dose group（n=45） and 40 mg·m-2 standard dose group（n=45）.The 3-year survival rates and the incidence of related toxic reactions in radiotherapy group and concurrent chemoradiotherapy group were compared.At the same time the 3-year survival rates and the incidence of related toxic reactions in 20 mg·m-2 low dose group and 40 mg·m-2 standard dose group were compared.Results The median follow-up time was 42（6-51） months.The 3-year survival rates in radiotherapy group and concurrent chemoradiotherapy group were 68.9% and 83.3%,the difference was statistically significant（χ2 = 3.858,P0.05）.The incidence of Ⅲ-Ⅳ acute toxic reactions in radiotherapy group was lower than that in concurrent chemoradiotherapy group（χ2 = 4.072,P0.05）.The 3-year survival rates in 20 mg·m-2 low dose group and 40 mg·m-2 standard dose group were 82.2% and 84.4%,there was no significant difference between two groups（χ2 =0.090,P0.05）.The incidence of acute toxic reactions in 20 mg·m-2 low dose group was significantly lower than that in 40 mg·m-2 standard dose group（χ2 =3.920,P0.05）.Conclusion Compared with radiotherapy alone,concurrent chemoradiotherapy can significantly improve the efficacy of ⅡB-ⅣA cervical carcinoma.In the concurrent chemoradiotherapy,compared with 40 mg·m-2 standard dose cisplatin,20 mg·m-2 low dose cisplatin doesn＇t reduce the effect of radiotherapy in patients,but reduce the incidence of Ⅲ-Ⅳ stage acute toxic reactions in patients.

关 键 词：顺铂 宫颈肿瘤 单纯放疗 同步放化疗 

分 类 号：R737[医药卫生—肿瘤]