顺铂与多西紫杉醇同步放化疗治疗中晚期宫颈癌64例疗效观察

Curative effect of cisplatin and docetaxel in concurrent chemotherapy and radiotherapy on medium-term and advanced cervical cancer:a report of 64 cases

目的探讨治疗中晚期宫颈癌同步放化疗的化疗药物选择。方法64例中晚期宫颈癌患者同步放化疗随机分成顺铂组(30例)及多西紫杉醇组(34例),两组在同样放疗的基础上,顺铂组同步给予顺铂40mg/m^2,每周1次,化疗6周;多西紫杉醇组同步给予多西紫杉醇25mg/m^2,每周1次,化疗6周。放疗方法:两组患者均采用^(60)Co全盆对穿两头照射野DT30Gy后,改为^(60)Co盆腔四野照射并后装治疗。观察两组的治疗效果和不良反应,并进行比较。结果外照射结束时两组的有效率分别为96.67%及100%,差异无显著性(P>0.05),两组4年生存率分别为56.67%及73.52%,差异有显著性(P<0.05),局部复发率分别为10.00%及5.88%,差异有显著性(P<0.05),远处转移率分别为8.82%及5.88%,差异有显著性(P<0.05)。顺铂组有较明显的骨髓抑制和消化道反应,而且肾功损害明显,差异有显著性(P<0.05)。结论多西紫杉醇同步放化疗能明显提高患者的生存率,降低局部复发率及远处转移率,副作用相对较轻。

Objective To investigate chemotherapy options of concurrent chemotherapy and radiotherapy for medium -term and advanced cervical cancer. Methods Totally 64 cases with medium term and advanced cervical cancer who were intended to be treated by concurrent chetherapy and radiotherapy were randomized into two groups： cisplatin group （n = 30） and docetaxel group （n = 34）. Both two groups underwent the same irradiation, while cisplatin group was given cisplatin at a dose of 40mg/m^2 every week once for 6 cycles and docetaxel group was given docetaxel at a dose of 25mg/m^2 every week once for 6 cycles. Both groups received radiotherapy with 30 Gy first and were irradiated by the combination of external radio- therapy plus intracavitary irradiation. Results The effective rate was 96. 67% in Group Cisplatin and 100% in Group Doeetaxel after radiotherapy （P 〉0. 05）. The four-year survival rate was 56. 67% in cisplatin group and 73.52% in doeetaxel group （P 〈0. 05）. Local reeurrentive rate was 10. 00% in eisplatin group and 5.88% in doeetaxel group （ P 〈 0. 05 ）. Distant metastasis rate was 8.82% in cisplatin group and 5.88% in Group Doeetaxel, showing a significant difference （P 〈0. 05）. Bone marrow inhibition, digestive tract advers and kidney damage, in Group Cisplatin, showing a significant difference （P 〈 0. 05）. Conclusion Doeetaxel can remarkably improve the survival rate, reduce local recurrence and distant metastasis and deereaee the side effect. Therefore, it is an appropriate drug for the concurrent chemotherapy and radiotherapy cervical cancer patients.