紫杉醇联合卡铂化疗同步调强适形放疗治疗晚期宫颈癌临床研究  

Clinical Study on Paclitaxel Combined with Carboplatin Chemotherapy and Intensity Modulated Radiation Therapy in the Treatment of Advanced Cervical Cancer

作　　者：朱必胜 肖秋菊 韩琦[1] 舒诚荣[1] 曾波航[2] Zhu Bisheng;Xiao Qiuju;Han Qi;Shu Chengrong;Zeng Bohang(Department eg gndoga,Kianning Central Hospital,The First Affiliated The First Affiliated Hospital of Hubei University of Science and Technology,Xianning,Hubei,China 437100;Department of Oncology,The Second Affiliated Hospital of Guangzhou Medical University,The Second Clinical College,Guangzhou,Guangdong,China 51026)

机构地区：[1]湖北省咸宁市中心医院.湖北科技学院第一附属医院肿瘤科,湖北咸宁437100 [2]广州医科大学附属第二医院.第二临床学院肿瘤科,广东广州510260

出　　处：《中国药业》2018年第24期40-43,共4页China Pharmaceuticals

基　　金：湖北省自然科学基金重点类项目[2015CFB412]

摘　　要：目的探讨紫杉醇联合卡铂化疗同步调强适形放疗治疗Ⅲ～Ⅳ期宫颈癌的临床疗效。方法选择咸宁市中心医院2013年3月至2014年12月收治的宫颈癌患者97例,按随机数字表法分为对照组(48例)和治疗组(49例)。对照组患者给予调强适形放疗,治疗组患者给予紫杉醇联合卡铂化疗同步调强适形放疗,两组均连续治疗4个疗程。结果治疗组的总有效率为79. 59%,明显高于对照组的47. 92%(χ~2=10. 548,P=0. 001 <0. 05);治疗组患者的3年生存率明显高于对照组患者(75. 51%比47. 92%),远处转移率和局部复发率均明显小于对照组患者(4. 08%比22. 92%,8. 16%比31. 25%,P <0. 05);治疗后,两组患者的认知功能、躯体功能、自觉功能、情绪功能及社会功能评分均明显升高,且治疗组明显高于对照组(P <0. 05);治疗后,两组患者的CD_3^+,CD_4^+及CD_4^+/CD_8^+均明显降低,且治疗组明显高于对照组(P <0. 05),CD_8^+均明显升高,且治疗组明显低于对照组(P <0. 05);两组患者的胃肠道反应、骨髓抑制的发生率均无明显差异(P> 0. 05)。结论紫杉醇联合卡铂化疗同步调强适形放疗治疗Ⅲ～Ⅳ期宫颈癌的近期和远期疗效均较好,能明显改善患者的生活质量,且对机体免疫功能影响较小,不良反应较轻,值得临床推广。Objective To investigate the clinical effect of paclitaxel combined with carboplatin chemotherapy and intensity modulated radiation therapy( IMRT) in the treatment of stage Ⅲ-Ⅳ cervical cancer. Methods Totally 97 patients with cervical cancer admitted to Xianning Central Hospital from March 2013 to December 2014 were selected and divided into the control group( 48 cases) and the treatment group( 49 cases) according to the random number table method. The control group was treated with IMRT,while the treatment group was treated with paclitaxel combined with carboplatin chemotherapy and IMRT. The two groups were treated for 4 consecutive courses. Results The total effective rate of the treatment group was 79. 59%,which was significantly higher than 47. 92% of the control group( χ^2 = 10. 548,P = 0. 001 < 0. 05). The 3-year survival rate of the treatment group was significantly higher than that of the control group( 75. 51% vs. 47. 92%),but the long-term metastasis rate and local recurrence rate of the treatment group were significantly lower than those of the control group( 4. 08% vs. 22. 92%,8. 16% vs. 31. 25%,P < 0. 05). After treatment,the scores of cognitive function,physical function,conscious function,emotional function and social function in the two groups were significantly increased,and those of the treatment group were significantly higher than those of the control group( P < 0. 05). After treatment,the levels of CD3+,CD4+and CD4+/CD8+in the two groups were significantly decreased,and those in the treatment group were significantly higher than those in the control group( P < 0. 05),the levels of CD8+in the two groups were significantly increased,but that in the treatment group was significantly lower than that in the control group( P < 0. 05). There was no significant difference in the incidence rates of gastrointestinal reaction and myelosuppression between the two groups( P > 0. 05). Conclusion Paclitaxel combined with carboplatin chemotherapy and IMRT in the treatment of stage Ⅲ-Ⅳ cervical canc

关 键 词：紫杉醇 卡铂 化学治疗 调强适形放射治疗 宫颈癌 疗效 生活质量 免疫功能 

分 类 号：R969.4[医药卫生—药理学] R979.1[医药卫生—药学]