多西他赛联合顺铂同期放化疗在宫颈癌治疗中的急性毒性反应分析  

Acute Toxicity Analysis aboute Docetaxel Plus Cisplatin Concurrent Chemotherapy and Radiotherapy in the Treatment of Cerrical Cancer

作　　者：党运芝 吕博[1] 李鑫[1] 刘隽悦[1] 周咏春[1] 李围围[1] 张莹[1] 李剑平[1] 魏丽春[1] 

机构地区：[1]第四军医大学西京医院放疗科,陕西西安710032

出　　处：《四川医学》2015年第6期791-794,共4页Sichuan Medical Journal

摘　　要：目的：比较宫颈癌放化同期治疗过程中,顺铂单药每周方案与多西他赛联合顺铂（ TP）方案化疗的急性毒性反应。方法回顾性分析2013年1月至2015年3月,我科收治的180例IB-IVB宫颈癌患者,放疗采用3-DCRT或IM-RT技术,1次/d,每周5次。化疗方案如下,顺铂单药组：共81例,化疗剂量40mg/m 2,每周1次,放疗期间化疗5~6周期；TP组：共计99例,多西他赛：60mg/m 2,注射用顺铂60mg/m 2,每3周1次,放疗期间化疗2周期。结果血液学毒性：顺铂单药组,32例患者出现Ⅲ-Ⅳ度骨髓抑制（39．5%）；而TP组30例（30．3%）,两组患者骨髓抑制发生率及严重程度差异无统计学意义（P=0．192）。而TP组患者的下消化道及泌尿系毒性均高于顺铂单药组。两组患者在放疗总时间差异无统计学意义,两组患者的初步疗效相似（P=0．92,1．0）。结论与单药顺铂每周方案相比,TP方案化疗并没有增加急性毒副反应,患者的耐受性较好。Objective To compare the acute side effects and feasibility of cocurrent chemoradiotherapy with cisplatin or with cispaltin plus docetaxel in the treatment of local advanced cervical cancer. Methods Between January 2013 and March 2014, 180 pa-tients with FIGO IB-IVB cervical cancer were analyzed. All patients in this study were treated with 3D-CRT （three-dimensional confor-mal radiotherapy） or IMRT （intensity modulated radiotherapy） external beam radiation therapy techniques through a 6 MV photon. The arm A received 5-6 cycles of cisplatin at a dose of 40 mg/m 2 , weekly. The arm B received 2cycles of docetaxel 60mg/m2 plus cisplatin 60mg/m2. Result Grade III–IV neutropenia occurred in 39. 5% in arm A and 30. 5% in the patients of arm B （P=0. 192）. The arm B presented higher lower digestive tract and urinary system complications rate. However, the overall radiotherapy time and primary response rate were similar in two group（P=0. 192）. Conclusion Cocurrent chemoradiotherapy with cispaltin plus docetaxel had similar acute side effect and can be well tolerated compared with cisplatin.

关 键 词：宫颈癌 顺铂 多西他赛联合顺铂(TP) 

分 类 号：R737.33[医药卫生—肿瘤] R730.55[医药卫生—临床医学]