ⅡB期宫颈鳞癌不同方案同步放化疗与单纯放疗的疗效及毒副反应比较  

Analysis of the efficacy and toxicities of concurrent chemoradiotherapy and radiotherapy alone in the treatment of stage ⅡB cervical squamous cell carcinoma

作　　者：杨治花[1] 张自新[1] 何剑莉[1] 海平[1] 折虹[1] 

机构地区：[1]宁夏医科大学总医院放疗科,宁夏银川750004

出　　处：《宁夏医学杂志》2014年第4期311-313,I0001,共4页Ningxia Medical Journal

基　　金：宁夏科技攻关计划项目(201125)

摘　　要：目的比较ⅡB期宫颈鳞癌单纯放疗、单药顺铂(P方案)同步放化疗、顺铂联合多西他赛(TP方案)同步放化疗的疗效及毒副反应。方法收集收治的ⅡB期宫颈鳞癌患者112例,34例选择单纯放疗,78例选择同步放化疗的患者按入院顺序随机分为P方案同步放化疗组(40例)和TP方案同步放化疗组(38例)。3组患者均给予相同的根治性放疗,P方案同步放化疗组在放疗第l、8、15、22、29天给予顺铂40 mg·(m2)-1静脉滴注;TP方案同步放化疗组在放疗第l、22天给予多西他赛75 mg·(m2)-1、顺铂50 mg·(m2)-1静脉滴注。结果单纯放疗组、P方案同步放化疗组、TP方案同步放化疗组,完全缓解率(CR)分别为82.35%、95.00%、92.11%;3年生存率分别为81.70%、94.60%、83.20%(P<0.05);3年无病生存率分别为69.10%、86.10%、77.50%(P<0.05)。单纯放疗组、P方案同步放化疗组、TP方案同步放化疗组≥3级白细胞下降发生率分别为32.35%、42.50%、52.63%(P>0.05);2级恶心、呕吐发生率分别为29.41%、27.50%、55.26%(P<0.05)。结论ⅡB期宫颈鳞癌同步放化疗与单纯放疗比较,有效率及生存率均有提高趋势,同步放化疗P方案较TP方案更易耐受。Objective To compare the efficacy and toxicities of single agent cisplatin （P） and cisplatin - docetaxe （TP） con- current chemoradiotherapy and radiotherapy alone in the treatment of stage ⅡB cervical squamous cell carcinoma. Methods 112 pa- tients with stage ⅡB cervical squamous cell carcinoma were registered. 78 patients were randomly divided into P group （n = 40） and TP group （ n = 38 ）. 34 patients who refused chemotherapy received radiotherapy alone. The same radiotherapy modality were delivered to all patients. Single agent cisplatin was given in a dose of 40 mg · （ m2 ） -l at day of 1,8,15,22 and 29. In the TP group ,doeetaxe and cispla- tin were given in a dose of 75 mg · （m2） -1 ,50 mg· （m2） -1 at day of 1 and 22. Results The CR rates were respectively 82.35%, 95.00% and 92.11% in the radiotherapy alone group,P group and TP group,81.70% ,94.60% and 83.20% for 3 -year survival rates （ X2 = 1.114 ,P 〉 0.05 ;3 - year disease free survival rates were 69.10% ,86.10% and 77.50% （ X2 = 0. 701 ,P 〉 0.05 ）. The incidence of grade 3 hematological toxicity were 32.35% ,42.50% and 52.63% in the radiotherapy alone group ,P group and TP group respective- ly,29.41% ,27.50% and 55.26% （ X2 = 7. 882,P 〈 0.05 ） for grade 2 gastrointestinal toxicity. Conclusion Comparing with radiother- apy alone, chemoradiotherapy trend to improve the overall survival and disease free survival rates of stage ⅡB cervical squamous cell car- cinoma. Single agent cisplatin is a little more efficacious and less toxic compared with TP regimen.

关 键 词：宫颈肿瘤 放射疗法 同步放化疗 

分 类 号：R737.33[医药卫生—肿瘤]