摘要
目的本文通过对常用的3种同步化疗方案的近期疗效及毒性反应进行回顾性分析,探索高效低毒的同步化疗方案。方法回顾性分析2014年1月1日‐2017年6月30日该院接受同步放化疗的249例宫颈癌患者,病理活检确诊为鳞癌或腺癌,国际妇产科协会(FIGO)分期为IB2～IVA期,根据同步化疗方案的不同分为3组,A组为多西他赛(75 mg/m^2)/紫杉醇(135 mg/m^2)+顺铂(75 mg/m^2)每3周给药1次;B组为单药顺铂(75 mg/m^2)每3周给药1次;C组为单药顺铂40 mg/m^2每周给药1次,观察3组的近期疗效及毒性反应。结果 A、B、C 3组的完全缓解率分别为:81%、79.7%、60.5%,差异有统计学意义(P=0.023),A组疗效整体优于C组(P=0.008),A、B组间疗效差异无统计学意义(P=0.847),B、C组疗效差异无统计学意义(P=0.046);近期毒性反应主要表现为白细胞减少,A、B、C 3组间白细胞减少发生率差异有统计学意义(P <0.05),C组的各级白细胞减少发生率均低于A、B两组(P <0.0125),但3组近期胃肠道反应、贫血、外周神经反应及膀胱反应发生率差异均无统计学意义。结论多西他赛/紫杉醇联合顺铂3周方案的近期疗效优于单药顺铂每周方案,毒性反应在可接受的范围内,可作为同步化疗给药方案的理想候选,远期生存获益有待进一步大样本临床试验验证。
【Objective】To compare the efficacy and toxicity of three common used concurrent chemotherapy regimens administration concurrent with radiotherapy in locally advanced cervical cancer.【Methods】A total of 249 patients with histologically proven squamous carcinoma or adenocarcinoma of stage IB2–IVA locally advanced cervical carcinoma（LACC） who were treated with concurrent chemoradiotherapy（CCRT） between 2014 and 2017 at Xiangya Hospital were retrospectively analyzed. The patients were divided into three groups according to the chemotherapy regimens. Group A consisted of paclitaxel（135 mg/m^2） or docetaxel（75 mg/m^2） day 1 plus cisplatin（75 mg/m^2） day 2 every 3 weeks for three cycles; group B consisted of cisplatin（75 mg/m^2） every 3 weeks for three cycles; group C consisted of cisplatin at 40 mg/m^2 weekly for six cycles. The short-term efficacy and toxicity between the three groups were investigated.【Results】The complete response（CR） rate in group A, B and C were 81%, 79.7%, 60.5% respectively, which was statistical significant（P =0.023）; CR rate in group A was superior to that in group C（P =0.008）, but there was no statistical significance of CR rate between group A and B（P =0.847）, B and C（P =0.046）. Leukopenia was the most common acute toxicity, and the difference in leukopenia rate between three groups was of statistical significance（P〈0.05）. Group C had the lowest leukopenia rate than group A and B（P〈0.0125）. However, there was no statistical significance of other toxicities between the three groups, and all the toxicities were acceptable and treatable.【Conclusion】The triweekly paclitaxel/docetaxel plus cisplatin regimen for CCRT seems more effective than the conventional weekly cisplatin regimen and may be a strong candidate for the optimal cisplatin dose and dosing schedule in the treatment of locally advanced cervical cancer, which should be validated by prospective larger sample clinical trials further.
作者
任康
申良方
周琴
黄昕琼
REN Kang, SHEN Liangfang, ZHOU Qin, HUANG Xinqiong(Department of Oncology Radiotherapy, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China)
出处
《中国医学工程》
2018年第10期1-7,共7页
China Medical Engineering
基金
国家自然科学基金青年基金(81602683)
关键词
局部晚期宫颈癌
同步化疗
近期疗效
locally advanced cervical cancer
concurrent chemotherapy regimens
short-term efficacy
