紫杉醇联合卡铂治疗晚期及复发性宫颈癌的可行性研究  

Feasibility of Cisplatin/Carboplatin Plus Paclitaxel for Advanced or Recurrent Cervical Cancer

作　　者：宋丹[1] 孔为民[1] 

机构地区：[1]首都医科大学附属北京妇产医院,100006

出　　处：《实用癌症杂志》2016年第3期421-424,共4页The Practical Journal of Cancer

基　　金：北京市科委重点项目(D131100005313009)

摘　　要：目的评估紫杉醇联合卡铂（TC）治疗晚期（ⅣB期）及复发性宫颈癌的疗效及安全性，并与传统的紫杉醇联合顺铂方案（TP）进行比较。方法晚期及复发性宫颈癌患者116例，其中TC组患者52例，应用紫杉醇联合卡铂方案化疗；TP组患者64例，应用紫杉醇联合顺铂方案化疗。比较两组的有效率、疾病控制率和总生存率，并记录患者的不良反应。结果TC组和TP组患者人口统计学、化疗前曾接受手术、放疗（或同步放化疗）方面比较无明显差异（P〉0．05）。TC组与TP组有效率（PR＋CR）分别为38．5％（20／52）、40．6％（26／64），疾病控制率（PR＋CR＋SD）分别为59．6％（31／52）、57．8％（37／64），差异均无统计学意义（P〉0．05）。TC组和TP组中位生存时间、5年生存率及总生存率比较差异均无统计学意义（P〉0．05）。TC组Ⅲ～Ⅳ级胃肠道反应发生率为5．7％，低于TP组23．4％，差异有统计学意义（P〈0．01）。TC组Ⅲ～Ⅳ级骨髓抑制、肾毒性比较，差异无统计学意义（P〉0．05）。TC组平均住院时间显著短于TP组，差异有统计学意义（P〈0．01）。结论TC和TP方案的有效率、疾病控制率和总生存率无明显差异，但是TC方案可明显降低胃肠道反应发生率，并缩短平均住院时间，因而在治疗晚期及复发性宫颈癌时值得应用。Objective To observe the efficacy and safety of paclitaxel combined with carboplatin （TC） and paclitaxel plus cisplatin（TP） in the treatment of advanced（ stage IV B） or recurrent cervical cancer. Methods A retrospective analysis of 116 cases of advanced（ stage IVB） or recurrent cervical carcinoma was involved in this randomized controlled trial. 52 cases were treated with TC and 64 cases were treated with TP. The overall response rate, disease control rate, overall survival rate and toxicity reactions between the 2 groups were compared. Results There were no statistical differences between the 2 groups in demographics, prior operation or radiation therapy（ concurrent ehemoradiotherapy） , or average number of cycles（ P 〉 0.05 ）. The overall response rate （PR ＋ CR） of TC group and TP group were 38.5 % （20/52） ,40.6% （26/64）, respectively. While the disease control rate（ PR ＋ C R ＋ SD） was 59.6% （31/52） in TC group vs 57.8% （37/64） in TP group. Median survival time,5-year survival rates and overall survival rates between the 2 groups had no significant difference （ P 〉 0.05 ）. There was a trend toward a larger number of patients in the TC group having grade Ⅲ～Ⅳ rash, gastrointestinal toxicity（ P 〈 0.01 ） , while there was no significant difference regarding the grade Ⅲ～Ⅳ bone marrow suppression, and renal toxicity （P 〉 0.05 ）. The average hospitalization time of TC group was shorter than that of TP group （ P 〈 0.05 ）. Conclusion Overall response rates, disease control rates and overall survival rates of TC group and TP group have no significant difference. TC group can decrease grade Ⅲ～Ⅳ gastrointestinal toxicity and administration time, and it is worthy of application in the treatment of advanced or recurrent cervical cancer.

关 键 词：宫颈癌 顺铂 卡铂 疗效 

分 类 号：R737.33[医药卫生—肿瘤]