紫杉醇联合顺铂、5-FU新辅助化疗晚期宫颈癌323例疗效对比观察

Neoadjuvant chemotherapy with paclitaxel,cisplatin and fluorouracil in 323 patients with advanced cervical cancer.

目的:对比观察紫杉醇联合顺铂(DDP)+5-氟尿嘧啶(5-FU)化学治疗晚期宫颈癌的疗效及毒副作用。方法:观察组323例:化疗第1天:紫杉醇150～180mg静脉滴注3h;第2～第6天每天经动脉导管推注5-FU 500mg、DDP20mg;对照组176例:在第1～第7天每天经动脉导管推注5-FU 500mg、DDP 20mg。两组均3～4周为1疗程,连续2～3个疗程。结果:化疗结束后4周检查,观察组中78例完全缓解,213例部分缓解,27例病情稳定,5例恶化,有效率(完全缓解+部分缓解)90．1%;54例因病灶明显缩小,接受了宫颈癌根治术;观察组总的5年生存率71%。对照组化疗结束后4周检查,176例中17例完全缓解,131例部分缓解,26例病情稳定,2例恶化,有效率为84．1%;14例因病灶明显缩小,接受了宫颈癌根治术;对照组总的5年生存率40%。两组近期疗效比较,差异无统计学意义(P＞0．05．);但两组5年后总生存状况比较,差异有显著统计学意义(P＜0．01)。结论:紫杉醇联合DDP、5-FU治疗晚期宫颈癌的疗效明显优于DDP+5-FU。

Objective：To investigate the antitumor actitivity and adverse effect of taxol （TAX）, cisplatin（DDP） and fluorouracil（5-FU） compared with DDP and 5-FU for patients with advanced cervical cancer. Methods： Between January 1995 and December 2000,323 patients （treatment group）with advanced cervical cancer were administered taxol 150 - 180mg indrip d1 ,5-FU 500mg and DDP 20mg intra-arterial given through inferior epigastric artery d2 - d7 and 176 patients （control group）with advanced cervical cancer were administered 5-FU 500mg and DDP 20mg intra-arterial chemotherapy through inferior epigastric artery d1 - d7, for 2 - 3 courses every 3 -4 weeks. Results：In the treatment group,78 patients achieved a clinical complete response （CR） ,213 partial response （PR）,27 stable disease （SD） and 5 showed disease progression （PD）. The response（ CR ＋ PR） rate was 90.1%. Fifty-four patients with obivious shrink of the tumor mass after chemotherapy were performed radical hysterectomy. Total survival rate was 71%. In the control group, 17 patients had achieved CR,131 PR,and 26 SD,2 patients PD, and the response rate was 84.1%. Fourteen patients with obivious shrink of the tumor mass after chemotherapy were carried out radical hysterectomy. Total survival rate was 40%. The short-term effects between the two groups were not significant different（ P 〉 0.05 ）, whereas srvival rate in the treatment group was significantly improved compared to that of the control group （ P 〈0. 01 ）. Neither treatment-related deaths nor significant toxicities were observed. Conclusion： The chemotherapy effect of TAX , DDP and 5-FU was significantly better than that of DDP and 5-FU for patients with advanced cervical cancer.