白蛋白结合型紫杉醇与紫杉醇脂质体治疗晚期和复发子宫颈癌患者的临床疗效对照研究  

Clinical Efficacy of Albuminbound Paclitaxel and Paclitaxel Liposome in the Treatment of Advanced and Recurrent Cervical Cancer

作　　者：温娜 边立华[2] 龚静[2] 孟元光[2] WEN Na;BIAN Lihua;GONG Jing(PLA 309th Hospital,Beijing 100091,China;Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]中国人民解放军第三〇九医院,北京100091 [2]解放军总医院,北京100853

出　　处：《实用妇产科杂志》2018年第12期935-938,共4页Journal of Practical Obstetrics and Gynecology

基　　金：军队后勤保障部研究项目基金(编号:16BJZ14).

摘　　要：目的:将白蛋白结合型紫杉醇联合顺铂应用于晚期和复发子宫颈癌患者的治疗,探讨其临床应用价值。方法:选择解放军总医院妇产科2015年1月至2018年1月期间诊治的晚期和复发子宫颈癌患者作为研究对象,采用前瞻性队列研究,根据化疗方案不同分为两组,观察组(n=52)采用白蛋白结合型紫杉醇+顺铂的治疗方案,对照组(n=49)采用紫杉醇脂质体+顺铂的治疗方案,比较两组的疗效和不良反应发生情况。结果:观察组的客观缓解率高于对照组[35例(67.3%) vs 23例(46.9%),P<0.05];两组疾病稳定、疾病进展和疾病控制率比较差异无统计学意义(P>0.05);观察组治疗费用高于对照组(25138.8±3540.7元 vs 14971.6±1633.5元,P<0.05)。观察组骨髓抑制[20例(38.5%) vs 31例(63.3%)]、周围神经症状[3例(5.8%) vs 11例(22.4%)]和过敏反应[0例(0) vs 4例(8.2%)]的Ⅲ～Ⅳ级不良反应发生率低于对照组,差异均有统计学意义(P<0.05);两组肝功能损害、肾功能损害和胃肠道反应的Ⅲ～Ⅳ级不良反应发生率比较差异无统计学意义(P>0.05)。结论:白蛋白结合型紫杉醇与顺铂联合用于治疗晚期和复发子宫颈癌,其疗效和安全性较紫杉醇脂质体联合顺铂更有优势,但昂贵的费用是其推广使用最大的障碍。Objective:To investivate the clinical application value of albumin bound paclitaxel +cisplatinin the treatment of advanced and recurrent cervical cancer.Methods:The advanced and recurrent cervical cancer patients in our hospital from January 2015 to January 2018 were enrolledin the prospective cohort study.All the patients were divided into two groups.The observation group(n =52)was treated with albumin binding paclitaxel + cisplatin ,while the control group(n =49)was treated with paclitaxel liposome +cisplatin.The efficacy and toxicity inthe two groups were compared.Results:The objective remission rate of the observation group was significantly higher than that of the control group [35 cases (67.3%)vs 23 cases (46.9%)](P<0.05).The cost of treatment in the observation group was higher than that in the control group [25138.8±3540.7 yuan vs 14971.6±1633.5 yuan](P<0.05).The incidences of Ⅲ-Ⅳ toxicity in myelosuppression [20 cases (38.5%)vs 31 cases (63.3%)],peripheral nerve symptoms[3 cases(5.8%)vs 11 cases(22.4%)]and allergic reactions[0 case(0) vs 4 cases(8.2%)]in the observation group were lower than those in the control group.And the differences were statistically significant(P<0.05).There was no significant difference in the incidence of Ⅲ-Ⅳ grade toxic reaction between the two groups in liver function impairment,renal impairment and gastrointestinal reaction (P>0.05).Conclusions:The chemotherapy protocol of albumin bound paclitaxel combined with cisplatin was more effective and saferthan paclitaxel liposome plus cisplatin in the treatment of advanced and recurrent cervical cancer.However,its applicated was limited by its high cost.

关 键 词：子宫颈癌 化疗 白蛋白结合型紫杉醇 紫杉醇脂质体 

分 类 号：R737.33[医药卫生—肿瘤]