宫颈癌术后放疗联合奈达铂不同化疗方案的疗效比较研究  

Comparative effectiveness study of different chemotherapy regimens of postoperative radiotherapy with nedaplatin for cervical cancer

作　　者：汤锐明[1] 刘殷红 王馨[1] 宋慧胜[1] 潘辉林[1] 冯正富[1] TANG Ruiming LIU Yinhong WANG Xin SONG Huisheng PAN Huilin FENG Zhengfu.(Department of Oncology, The Sixth Affiliated Hospital of Guangzhou Medical University, The Sixth Clinical College of Guangzhou Medical Unicersitg, Qingyuan 511500, China)

机构地区：[1]广州医科大学附属第六医院(广州医科大学第六临床学院)肿瘤科一区,广东清远511500

出　　处：《中国肿瘤外科杂志》2017年第3期167-170,173,共5页Chinese Journal of Surgical Oncology

基　　金：广东省清远市科技项目(2012B011204028)

摘　　要：目的比较在早期高危宫颈癌术后同步放化疗中,奈达铂单周1次与3周1次方案的毒副反应及疗效。方法收集2012年7月至2014年7月,广州医科大学附属第六医院收治的60例宫颈癌患者的临床资料,用信封法随机分为单周组和3周组各30例。化疗方案选用奈达铂单药,按需予30 mg/m^2(单周组)或75 mg/m^2(3周组)加入生理氯化钠溶液500 ml中静脉滴注。放疗选用三维适形放疗±腔内后装放疗。盆腔放疗剂量为Dt 50 Gy/5 w,阴道切除长度不足2 cm者补充阴道腔内放疗25~30 Gy/4~5次,阴道残端见癌肿者补充阴道腔内放疗30~36 Gy/5~6次,淋巴结残留者局部加量至Dt 60 Gy。分析评定两组毒副反应及疗效。结果 60例宫颈癌患者术后病理提示具有高危因素。奈达铂单周组和3周组在血液学毒性、肝肾毒性、胃肠道毒性、放射性膀胱炎、放射性直肠炎及神经毒性等方面比较,差异无统计学意义(均P>0.05)。随访至2015年1月,两组患者均未出现死亡,近期疗效比较,差异无统计学意义(P>0.05)。结论在早期宫颈癌术后同步放化疗中,奈达铂单周1次与3周1次方案的毒副作用和近期疗效比较无差异。3周方案可减少门诊放化疗患者输液次数、节省医疗费用,减轻患者医疗负担,可作为早期宫颈癌术后的同步化疗方式之一。Objective To compare the efficacy and toxicity of nedaplatin （NDP） given weekly and ev- ely three weeks in the postoperative chemo-radiotherapy on early stage postoperative cervical cancer with high- risk factors. Methods Sixty postoperative cervical cancer patients with high-risk factors from the authors＇ affili- ated hospital were randomized into two groups, including the QW group （ n = 30 ） and the Q3W group （ n = 30 ） , which received NDP-QW （NDP 30 mg/mZin 500 ml sodium chloride physiological solution, weekly） and NDP-Q3W regiment （ NDP 75 mg/m2 in 500 ml sodium chloride physiological solution, every 21 days） , respec- tively. All the patients received the concurrently radiotherapy with 2DRT or 3DCRT. The radiotherapy dose was Dt 50 Gy/5 w. Patients with tumor at vaginal stump and close vaginal mucosal surgical margins （ 〈 2 em） re- ceived vaginal brachytherapy at a dose of 30 - 36 Gy/5 - 6 Fx and a dose of 25 - 30 Gy/4 - 5 Fx, respectively. Patients with unresected lymph nodes may be boosted with an additional Dt 60 Gy of highly eonformal EBRT. The adverse reactions and efficacy of the two groups were analyzed and evaluated. Results Postoperative pa- thology showed 60 cases of cervical cancer with high-risk factors. There were no statistically differences in be-matological toxicity, liver injure and the nephrotoxicity, gastrointestinal toxicity, radiation cystitis, radiation proctitis and neurotoxicity between the two groups （ all P 〉 0. 05 ）. The 2-year overall survival showed no statis- tically significant differences in different groups without any death （ P 〉 0.05）. Conclusions Nedaplatin showed well tolerance in the use of the concurrently chemo-radiotherapy of cervical cancer patients with high-risk factors, no matter given by weekly or every 3 weeks. Every 3 weeks nedaplatin regiment could be another choice with decreased infusion number of outpatient chemotherapy and radiotherapy, low medical expenses, and re- duced burden of medical treatment in the postopera

关 键 词：宫颈肿瘤 药物疗法 联合 化放疗 疗效比较研究 奈达铂 

分 类 号：R737.33[医药卫生—肿瘤]