氨磷汀对宫颈鳞癌同步放化疗的骨髓保护作用  

Protective effect of amifostine on bone marrow in concurrent chemoradiotherapy for cervical squamous cell carcinoma

作　　者：李昉[1] 宋燕琼 刘爱祥[1] 张德康[1] 

机构地区：[1]四川省肿瘤医院放疗科,四川成都610041

出　　处：《西部医学》2016年第9期1234-1237,共4页Medical Journal of West China

基　　金：四川省卫生厅科研课题(120036)

摘　　要：目的 探讨氨磷汀对宫颈鳞癌患者同步放化疗的骨髓保护作用。方法 选取确诊为Ⅱ~Ⅲ期宫颈鳞癌患者34例,采用数字随机法将患者分为对照组和观察组各17例。对照组给予多西紫杉醇与奈达铂联合化疗（DP）方案,观察组在DP方案基础上＋氨磷汀治疗,两组患者放疗方式均为宫颈癌体外照射加腔内照射,评估两组近期疗效及2年总生存率和无进展生存率,治疗前后患者身体状况评分（KPS）,检测两组患者白细胞、红细胞及血小板计数并对比最低值,评估两组化疗毒副反应。结果 两组近期疗效及2年总生存率和无进展生存率差异无统计学意义（P〉0.05）;观察组白细胞最低值、血小板最低值分别为（2.91±2.01）×109/L、（119.64±56.38）×109/L,均显著高于对照组,差异有统计学意义（P〈0.05）;观察组化疗后KPS评分为（84.64±6.38）分,显著高于对照组的（70.16±3.69）分,差异亦有统计学意义（P〈0.05）;观察组白细胞Ⅲ~Ⅳ级毒性反应、血小板Ⅲ~Ⅳ级毒性反应发生率分别为23.53%和5.88%,均显著低于对照组,差异均有统计学意义（P〈0.05）。观察组患者的主要不良反应为恶心、呕吐、低血压、头晕、嗜睡和打喷嚏等,经预处理和对症处理后均能耐受。结论 氨磷汀联合同步放化疗对宫颈鳞癌患者近期疗效无影响,可降低化疗毒性反应,对骨髓具有一定保护作用,但尚有待大样本的进一步临床研究证实。Objective To investigate the protective effect of amifostine to bone marrow in concurrent chemoradiotherapy for cervical squamous cell carcinoma. Methods 34 patients with confirmed stage Ⅱ-Ⅲ cervical squamous cell carcinoma from November 2011 to November 2013 were randomly divided into the control group and the observation group by random number method, with 17 cases in each group. The control group was treated with paclitaxel and nedaplatin combined with chemotherapy （TP） regimen, while the observation group with TP regimen and amifostine. The radiation methods were in vitro and in the uterine cavity. The short-term curative effect, the rates of 2-year overall survival and progression free survival were evaluated. Karnofsky performance status （KPS） score was performed before and after chemotherapy. Blood samples were collected to detect white blood cells, red blood cells and platelet count and the lowest values were compared. The side effects of chemotherapy in the 2 groups were evaluated. Results The differences in short-term curative effect and 2- year OS and PFS were not significant （P〉0.05）. The lowest values of white blood cells and blood platelets of the observation group/-（2.91 ±2.01）× 10^9/L, （119. 644-56.38） ）〈 109/L] were significantly higher than those of the Control group （P〈0.05）. The KPS score（84.64 4- 6.38）of the observation group after chemotherapy was significantly higher than that of the control group （70. 164-3.69） （P〈0.05）. Ⅲ -Ⅳ level toxic reactions of white blood cells and blood platelets in the observation group accounted for 23.53% and 5.88%, respectively, which were significantly lower than those in the control group （P〈0.05）. The main adverse reactions of the 17 patients in the observa tion group were nausea, vomiting, hypotension, dizziness, drowsiness, sneezing and so on, which were obviously improved after pretreatment and symptomatic treatment. Conclusion Amifostine combined with concurrent chemoradiotherapy has no effect

关 键 词：氨磷汀 宫颈鳞癌 同步放化疗 骨髓保护 

分 类 号：R737.33[医药卫生—肿瘤]