调强放疗联合奈达铂单药与PF方案治疗局部晚期子宫颈癌的疗效比较  

Efficacy and toxicities of PF regimen or nedaplatin combined with intensity modulated radiotherapy for locally advanced cervical cancer

作　　者：闫春梅[1] 蔡宏懿[1] 王建凯[1] 王海琳[2] 

机构地区：[1]甘肃省人民医院肿瘤放疗科,甘肃兰州730000 [2]甘肃省人民医院妇产科,甘肃兰州730000

出　　处：《实用肿瘤杂志》2013年第4期371-373,共3页Journal of Practical Oncology

摘　　要：目的探讨调强放疗联合奈达铂单药用于局部晚期子宫颈癌同步化疗与PF方案同步化疗的近期临床疗效及不良反应。方法对62例局部晚期子宫颈癌患者均采用盆腔外照射调强放疗和腔内后装治疗的放疗方案,放疗期间随机分为两组同步化疗:单药奈达铂方案组(N组)32例,5-氟尿嘧啶加顺铂方案组(PF组)30例,比较2种方案的近期疗效和不良反应。结果 62例患者全部完成同步放化疗。N组CR率为93.8%,PF组为93.3%(P>0.05)。N组和PF组有效率均为100.0%(P>0.05)。两组主要不良反应有骨髓抑制、胃肠道反应、肾毒性反应。其中N组和PF组Ⅲ度以上白细胞减少发生率分别为6.3%和20.0%,Ⅲ度以上血小板减少发生率分别为3.1%和10.0%,Ⅲ度以上胃肠道反应发生率分别为6.3%和23.3%,差异均有统计学意义(均P<0.05)。结论调强放疗联合单药奈达铂同步放化疗与PF方案同步放化疗,均能提高子宫颈癌患者近期疗效,不良反应均可以耐受;2种化疗方案疗效相近;单药奈达铂同步放化疗不良反应较轻,患者更易耐受。Objective To compare the efficacy and toxicities of PF regimen and nedaplatin combined with intensity modulated radiotherapy in treatment of locally advanced cervical cancer. Methods Sixty-two patients with locally advanced cervical cancer undergoing intensity modulated radiotherapy were randomly assigned to two groups： 30 cases received concurrent cisplatin-fluorouracil regimen （PF group） and 32 cases received nedaplatin monochemotherapy （N group）. The efficacy and toxicities of two groups were compared. Results All cases completed concurrent radiotherapy. CR rate for PF and N groups was 93.3% and 93.8%, respectively （ P 〉 0.05 ）. The main toxicities of the two groups were marrow suppression, gastrointestinal reaction and nephrotoxiticy. The incidence rate of leucopenia （ grade HI and 1V ） was 6.3% in N group and 20.0% in PF group （ P 〈 0. 05 ）. The incidence rate of thrombopenia （grade III and IV） was 3.1% in N group and was 10.0% in PF group （P 〈0.05）. The incidence rate of gastrointestinal reaction （ grade IU and IV ） was 6.3% in N group and 23.3% in PF group （ P 〈 0.05 ）. Conclusions Intensity modulated radiotherapy combined with concurrent chemotherapy with nedaplatin or PF regimen can improve the short term efficacy of patients with locally advanced cervical cancer. The toxicity of nedaplatin is milder and can be easier tolerated than PF regimen.

关 键 词：宫颈肿瘤 药物疗法 宫颈肿瘤 放射疗法 有机铂化合物 治疗应用 综合疗法 治疗结果 

分 类 号：R737.33[医药卫生—肿瘤] R730.53[医药卫生—临床医学]