长疗程紫杉醇联合洛铂方案在Ⅲ期子宫内膜癌患者根治术后辅助治疗中的近期疗效及生活质量观察  

The Observation of Short-Term Efficacy and Quality of Life of Patients with Stage Ⅲ Endometrial Carcinoma After Operation Treated with Long-Course Paclitaxel Plus Lobaplatin Chemotherapy as a Adjuvant Therapy

作　　者：徐蕾[1] 吴玲姣[1] 吴宝华 张杰[1] Xu Lei;Wu Lingjiao;Wu Baohua(Department of Gynecology,Department of Oncology,Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College,Chengdu,Sichuan 610500,China.)

机构地区：[1]成都医学院第一附属医院妇科,肿瘤科,四川成都610500

出　　处：《四川医学》2021年第12期1230-1236,共7页Sichuan Medical Journal

摘　　要：目的观察长疗程紫杉醇联合洛铂方案在Ⅲ期子宫内膜癌患者根治术后辅助治疗中的近期疗效及对患者生活质量的影响。方法选择2013年5月至2019年6月我院收治的子宫内膜癌术后分期为Ⅲ期的患者共82例,用随机数字表法分为紫杉醇联合卡铂组(TC组)及紫杉醇联合洛铂组(TL组)。TC组辅助放疗前后各给予TC方案化疗2周期。TL组放疗前给予2周期,放疗后6周期TL方案化疗。观察无疾病进展时间(DFS)、两组患者的不良反应及生活质量的各项指标。结果TC组中位DFS为20.00个月,95%可信区间(95%CI 14.86~25.14个月)。TL组中位DFS为24.00个月,95%CI 20.11~27.89个月。两组DFS的比较差异无统计学意义(P=0.082)。不良反应的比较TL组在轻度白细胞降低、轻度恶心呕吐、中重度白细胞降低及中重度血小板降低方面高于TC组,差异有统计学意义(P=0.022,P=0.008,P=0.040,P=0.046)。其余不良反应比较差异均无统计学意义(P>0.05)。两组患者基线评估时生活质量量表中的功能子量表比较差异均无统计学意义。TC治疗结束时(放疗后行两周期化疗后),TC组在躯体功能子量表的比较优于TL组,差异有统计学意义(P=0.000),其余功能子量表两组间的比较差异均无统计学意义(P>0.05)。TL治疗结束时(放疗后行6周期化疗后),TC组在躯体功能、角色功能、社会功能及总体健康状况等方面两组之间的比较均优于TL组,差异有统计学意义(P=0.005,P=0.006,P=0.000,P=0.000),其余子量表两组之间的比较差异无统计学意义(P>0.05)。结论长疗程紫杉醇联合洛铂方案较传统紫杉醇联合卡铂方案在Ⅲ期子宫内膜癌患者术后辅助治疗中未能显示出短期疗效的统计学差异,其不良反应较多且主要为化疗相关骨髓抑制,对患者生活质量也有一定程度的影响。考虑到TL组中位DFS上显示出的优势趋势,还需进一步增加样本量观察。Objective To observe the short-term efficacy and quality of life(QoL)on long-course TP(paclitaxel plus lobaplatin)chemotherapy in adjuvant therapy of stage Ⅲ endometrial carcinoma(EC)patients after operation.Methods From 2013.05.05 to 2019.6.30,82 cases of pathological stage Ⅲ EC patients were collected and randomly divided into TC(paciltaxel plus carboplatin)group and TL(paciltaxel plus lobaplatin)group.Patients of TC group were given two cycles of TC regimen before and after adjuvant radiotherapy, patients of TL group were given two cycles of TL regimen before radiotherapy and up to six cycles of TL regimen after adjuvant radiotherapy.Disease-free survival(DFS),the adverse events of each group, and the index of each patients’ QoL from different periods were observed.Results Median DFS of TC group and TL group were 20.00(month)and 24.00(month),respectively, with no statistically significant difference between two groups(P=0.082).TL group had higer incidence of mild leucopenia, mild nausea and vomiting, severe leucopenia, severe thrombocytopenia cases than that of TC group and there were statistically significant differences between two groups(P=0.022,P=0.008,P=0.040,P=0.046).There were no statistically significant difference of other adverse events between two groups(P>0.05).There were no statistically significant differences between the functional subscales of the QoL at baseline between the two groups..At the end of TC treatment(after two cycles of chemotherapy after radiotherapy),the comparison of physical function subscales in TC group was better than that in TL group, with statistical difference(P=0.000),while there were no statistical differences in other functional subscales between the two groups(P>0.05).At the end of TL treatment(after six cycles of chemotherapy after radiotherapy),the TC group was superior to the TL group in terms of physical function, role function, social function and overall health status, with statistical differences(P=0.005,P=0.006,P=0.000,P=0.000).There were no significant

关 键 词：长疗程 洛铂 子宫内膜癌 术后辅助治疗 疗效 

分 类 号：R737.33[医药卫生—肿瘤]