宫颈鳞癌同步放化疗中顺铂联合紫杉醇方案单周与3周疗法的比较研究  

Comparative study between weekly and triweekly paclitaxel and cisplatin regimen in concurrent chemoradiotherapy for cervical squamous cell cancer

作　　者：李雨聪[1] 周琦[1] 

机构地区：[1]重庆市肿瘤医院妇瘤科,400030

出　　处：《检验医学与临床》2016年第17期2420-2422,共3页Laboratory Medicine and Clinic

基　　金：重庆市科技计划项目(cstc2015jcsf0097)

摘　　要：目的比较和评价中晚期宫颈鳞癌同步放化疗中顺铂联合紫杉醇方案单周疗法与3周疗法的不良反应及近期疗效。方法对112例Ⅱb至Ⅲb期宫颈鳞癌患者进行前瞻性随机分组对照研究,采用完全随机设计方法,把符合入组条件的患者分成单周方案组和3周方案组各56例。单周方案组:紫杉醇50mg/m^2,顺铂25mg/m^2,1次/周,连用6周;3周方案组:第1天紫杉醇150mg/m^2,第2天顺铂70mg/m^2,21d为1个周期,共2周期。两组的放疗均采用三维适形放疗+后装治疗,A点总剂量75~85Gy。同步放化疗过程中如实记录患者的不良反应,治疗结束后4月根据肿瘤退缩情况判定近期疗效。结果不良反应:单周方案组消化道反应、骨髓抑制、神经毒性均低于3周方案组,差异有统计学意义(P<0.05)。近期疗效:单周方案组和3周方案组病情缓解率分别为91.1%和94.6%,差异无统计学意义(P>0.05)。结论中晚期宫颈鳞癌同步放化疗顺铂联合紫杉醇方案单周疗法较3周疗法不良反应明显降低,近期疗效相当,但远期疗效有待进一步观察。Objective To compare and evaluate the toxicity and short-term effect of weekly paclitaxel and cisplatin regimen and tri-weekly paclitaxel and cisplatin regimen therapy in concurrent chemoradiotherapy for advanced cervical squamous cell cancer. Methods A prospective randomized controlled study was performed in patients with cervical squamous cell cancer of Ⅱ b to Ⅲ b stage. A completely randomized design was used and 112 patients enrolled in the study were divided into weekly and triweekly regimen group equally（n=56）. 50 mg/m2 of paclitaxel and 25 mg/m2 of cisplatin were administrated once per week for six weeks in weekly regime group; 150 mg/m2 of paclitaxel on Days 1 and 70 mg/m2 of cisplatin on Days 2 were administrated in triweekly re gime group for two courses, each course needed 21 days. Both groups underwent three-dimensional conformal radiotherapy plus a brachytherapy, the planed total dose to A point was 75--85 Gy. Toxicity of concurrent chemoradiotherapy was recorded accurately; short term effect was evaluated on the basis of tumor regression after four months of treatment. Results Weekly regime group had lower side effects in gastrointestinal reactions, bone marrow suppression and neurotoxicity than triweekly regime group, the differences were statistically significant（P〈0.05）. Remission rates in weekly and triweekly regime group were 91.1% and 94.6 %, respectively; there was not any statistically significant difference（P〉0.05）. Conclusion In concurrent chemoradiotherapy,compared with weekly paclitaxel and cisplatin regime, the triweekly regime has lower toxicity while similar short-term effect, and long-term effect still needs further observation.

关 键 词：宫颈癌 同步放化疗 化疗方案 

分 类 号：R737.33[医药卫生—肿瘤]