紫杉醇脂质体在中晚期宫颈癌治疗的效果分析

Therapeutic effect of paclitaxel liposome combined with cisplatin for Ⅲ～Ⅳ degrees of cervical cancer

目的观察紫杉醇脂质体未作预处理在同步放化疗治疗中晚期宫颈癌中的疗效及安全性。方法采用随机分组的方法将32例患者分为治疗组和对照组。治疗组应用紫杉醇脂质体第1天为135mg/m2,联合使用顺铂,每3周为1个周期,共3个周期;对照组应用紫杉醇第1天135mg/m2,联合使用顺铂,每3周为1个周期,共3个周期。结果治疗组15例,治疗有效率为66.7%,骨髓抑制7例(46.7%),胃肠反应6例(40.0%);对照组17例,治疗有效率为64.7%,骨髓抑制14例(82.4%),胃肠反应13例(76.5%)。两组治疗有效率相似,但治疗组骨髓抑制及胃肠反应较轻,经比较有显著性差异(χ2分别为4.50、4.39,均P<0.05)。结论紫杉醇脂质体化疗前不用作大剂量激素预处理,可免除大剂量激素副作用的影响,患者耐受性好,值得临床推广。

Objective To evaluate therapeutic effect and safety of paclitaxel liposome combined with cisplatin for patients with Ⅲ-Ⅳ degrees of cervical cancer in concurrent chemoradiotherapy in absence of pretreatment. Methods 32 patients with cervical cancer were randomly divided into research group （n = 15） and control group （n = 17）. The patients in the research group were treated with paclitaxel liposome combined with cisplatin （TP regimen： 135mg/m^2 of paclitaxel liposome at the first day given intravenously lasting for at lest 3 hours, 55mg/m^2 of cisplatin fractionally given in the first two days, there after the patients were not given any chemotherapeutic agents. 3 weeks was as a cycle and the patients received 3 treatment cycles totally）. Those patients in the control group were treated with paclitaxel combined with cisplatin（TP regimen： same usage as in the research group ）. Treatment was repeated every three weeks, at the end of the treatment cycle, the therapeutic effects in the two groups were evaluated. Results The total effective rates were 66.7% in the research group and 64.7% in the control group and thaws no significant difference between the two groups （P 〈 0.05 ）. The side effects included myelosuppression （46.7% vs 82.4% ）, gastrointestinal reactions（40.0% vs 76.5% ） and there were significant differences between the two groups in side effects （χ^2 = 4.50, 4. 39, respectively, both P 〈 0. 05 ）. Conclusion In TP regimen with paclitaxel liposome, pretreatment with corticoid was not needed, which exempts side effects of the hormone. TP regimen with paclitaxel liposome had same therapeutic effect to TP regimen with paclitaxel and less side effects.