不同放疗方案联合紫杉醇脂质体和顺铂治疗局部晚期宫颈癌临床比较  

Comparison of Different Radiotherapy Regimens Combined with Paclitaxel Liposome and Cisplatin in the Treatment of Locally Advanced Cervical Cancer

作　　者：尹树旺 彭丽艳 韩秀青[1] 石冲[1] YIN Shuwang;PENG Liyan;HAN Xiuqing;SHI Chong(Tangshan Maternal and Child Health Hospital,Tangshan,Hebei,China 063000)

机构地区：[1]河北省唐山市妇幼保健院,河北唐山063000

出　　处：《中国药业》2022年第4期97-101,共5页China Pharmaceuticals

基　　金：河北省自然科学基金[H2016105060]。

摘　　要：目的比较调强放射治疗(IMRT)和容积调强弧光治疗(VMAT)联合紫杉醇脂质体和顺铂治疗局部晚期宫颈癌的疗效和安全性。方法选取医院2017年3月至2019年12月收治的Ⅱb-Ⅲb期宫颈癌患者126例,按治疗方案的不同分为IMRT组和VMAT组,各63例,采用IMRT及VMAT分别联合紫杉醇脂质体和顺铂治疗。结果IMRT组和VMAT组的客观缓解率分别为88.89%和96.83%(P>0.05)。两组患者治疗后的CD_(3)^(+)和CD_(4)^(+)水平,CD_(4)^(+)/CD_(8)^(+)均显著升高,CD_(8)^(+)水平均显著降低,但组间无显著差异(P>0.05);与治疗前比较,两组患者治疗后的血清血管内皮生长因子、鳞癌抗原、白细胞介素8、肿瘤坏死因子-α、癌胚抗原、糖类抗原125水平均显著降低,且VMAT组低于IMRT组(P<0.05);VMAT组骨髓抑制发生率显著低于IMRT组(P<0.05)。结论IMRT和VMAT分别联合紫杉醇脂质体和顺铂治疗Ⅱb-Ⅲb期宫颈癌短期临床疗效和长期生存率相当,但VMAT在降低血清炎性因子和肿瘤标志物水平方面更具优势。Objective To compare the efficacy and safety of intensity-modulated radiation therapy(IMRT)or volumetric intensity-modulated arc therapy(VMAT)combined with paclitaxel liposome and cisplatin in the treatment of locally advanced cervical cancer.Methods A total of 126 patients with stageⅡb-Ⅲb cervical cancer admitted to the hospital from March 2017 to December 2019 were selected and divided into the IMRT group and the VMAT group,with 63 cases in each group.The patients in the IMRT group were treated with IMRT combined with paclitaxel liposome and cisplatin,while the patients in the VMAT group were treated with VMAT combined with paclitaxel liposome and cisplatin.Results The objective remission rates of the IMRT group and the VMAT group were 88.89%and 96.83%,respectively(P>0.05).After treatment,the levels of CD_(3)^(+)and CD_(4)^(+),and the CD_(4)^(+)/CD_(8)^(+)in the two groups were significantly higher than those before treatment,while the levels of CD_(8)^(+)in the two groups were significantly lower than those before treatment,but there was no significant difference between the two groups(P>0.05).After treatment,the levels of serum vascular endothelial growth factor(VEGF),squamous cell carcinoma antigen(SCCA),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α),carcinoembryonic antigen(CEA)and carbohydrate antigen 125(CA125)in the two groups were significantly lower than those before treatment,and those in the VMAT group were significantly lower than those in the IMRT group(P<0.05).The incidence of bone marrow suppression in the VMAT group was significantly lower than that in the IMRT group(P<0.05).Conclusion IMRT or VMAT combined with paclitaxel liposome and cisplatin has similar short-term clinical efficacy and long-term survival rate in the treatment of stageⅡb-Ⅲb cervical cancer,but VMAT has more advantages in reducing the levels of serum inflammatory factors and tumor markers.

关 键 词：紫杉醇 顺铂 调强放射治疗 晚期宫颈癌 

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