三维适形放射治疗同步顺铂或奈达铂化疗治疗中晚期宫颈癌的疗效比较  

Effect comparison of concurrent chemoradiotherapy in advanced cervical cancer with cisplatin and nedaplatin

作　　者：段伟[1] 康婷[1] 高娜[1] 刘敏[1] 刘宁宁[1] 

机构地区：[1]陕西延安大学附属医院肿瘤科,延安716000

出　　处：《中国肿瘤临床与康复》2013年第9期975-977,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨三维适形放射治疗同步顺铂或奈达铂化疗治疗中晚期宫颈癌的疗效及不良反应。方法 2006年10月至2008年3月收治的60例中晚期宫颈癌患者,采用随机数字法分为奈达铂组（30例）和顺铂组（30例）,外照射采用盆腔四野盒式照射,95%PTV 45-50Gy,每次1.8-2Gy分25次,后装治疗采用192Ir后装治疗机,A点剂量36-42Gy,每次6Gy分6-7次。奈达铂组给予奈达铂每周30mg/m2,顺铂组给予顺铂每周30mg/m2,放射治疗第1、8、15、22、29、36天给药。结果两组患者有效率均达100%。奈达铂组患者完全缓解率为83.3%,顺铂组为73.3%（P〉0.05）。两组患者3年总生存率差异无统计学意义。奈达铂组患者胃肠道反应（X2=7.445,P〈0.05）和肾功能损伤（X2=5.420,P〈0.05）明显低于顺铂组,而血小板下降发生率明显高于顺铂组（X2=9.320,P〈0.05）,但主要为Ⅰ/Ⅱ级。结论奈达铂或顺铂联合同步放射治疗治疗中晚期宫颈癌疗效相似,但奈达铂的耐受性优于顺铂。Objective To compare the efficacy and toxicity of weekly cisplatin or nedaplatin con- current chemotherapy and three-dimensional conformal radiotherapy for locally advanced cervical cancer. Methods From Oct 2006 to Mar 2008, 60 cases with locally advanced cervical cancer pathologically proved were randomly divided into nedaplatin group and eisplatin group based on random number method. Patients in both groups were received conventional external radiation of pelvic cavity. Patients in nedaplatin/ cisplatin group received weekly nedaplatin/cisplatin 30mg/m2begun at the dl of radiotherapy. Results The overall response rate of two groups was both 100% , and the CR rate （CRR） in nedaplatin group and cispla- tin group was 83.3% and 73.3% ,respectively （P 〉0. 05）. The 3-years overall survival of the two groups had no significant difference. The gastrointestinal toxicity （ X^2 = 7. 445, P 〈 0. 05 ） and renal toxicity （ X^2= 5. 420, P 〈 0.05 ） in nedaplatin group were less than those in eisplatin group, while thrombocytopenia was higher than that in cisplatin group （ X^2 = 9. 320, P 〈 0. 05 ） ）, but mainly grade Ⅰ/Ⅱ. Conclusions The efficacy of concurrent cisplatin or nedaplatin-based chemoradiation for locally advanced cervical cancer is similar, however, the tolerance of nedaplatin is superior to cisplatin.

关 键 词：宫颈肿瘤 奈达铂 顺铂 三维适形放射治疗 同步放化疗 

分 类 号：R737.33[医药卫生—肿瘤]