卡培他滨联合奈达铂同步放化疗宫颈复发癌的疗效分析

Result of capecitabine and nedaplatin combined with concurrent radiotherapy for recurrent cervical cancer

目的探讨同步放化疗（concurrent chemoradiotherapy，CCRT）治疗宫颈复发癌的疗效和毒性反应。方法2003年10月-2006年11月共收治宫颈复发癌41例，采用三维适形放疗（3-dimensional conformal radiotherapy，3DCRT），总量50Gy-65Gy，同步化疗方案为卡培他滨（capecitabine）1500ms／m^2，分2次口服第1天-14天，奈达铂（nedaplatin，NDP）60mg／m^2，静脉滴注第1天，21天为一周期，与放疗同时开始，共2周期，CCRT结束后1个月相同方案巩固化疗2—4周期。结果所有患者完成了CCRT，33例完成4个疗程巩固化疗，3例完成3个疗程，5例完成2个疗程。临床完全缓解（complete response，CR）26．8％（11／41），部分缓解（partial response，PR）51．2％（21／41），有效率78％；中位生存期24．8个月；1、2年生存率分别为58．5％、31．7％；疼痛缓解率90．3％（24／31），出血完全缓解90．9％（10／11），生活质量明显改善，无治疗相关性死亡。结论卡培他滨＋顺铂同步放化疗治疗宫颈复发癌疗效高，可以提高局部控制率和延长生存期，提高生活质量，毒副反应能够耐受。

Objective To explore the efficacy and toxic reaction of concurrent chemoradiotherapy for recurrent cervical cancer. Methods Form October 2003 to November 2006,41 recurrent cervical cancer patients were treated by 3DCRT of 50 - 65 Gy. Chemotherapy was given concurrently using capecitabine （ 1500 rag/ m^2 orally, d1 - d14,21 days per cycle） and nedaplatin （60 mg/m^2 iv drop, d1,21 days per cycle）. The concurrent chemotherapy was used 2 circles. After CCRT,2 -4 circles of the same program for consolidation chemotherapy were used one month later. Results All of the patients had finished the CCRT,in which 33 patients were given consolidation chemotherapy for 4 cycles ,3 patients were given 3 cycles and 5 patients were given 2 cycles. The total response,complete response rate and partial response rate were 78% ,26.8% （11/41）and 51.2% （21/41）, respectively. The medium overall survival was 24.8 months. The 1 - and 2 - year survival rates were 58.5% and 31.7% respectively. The pain - alleviation rate and the mean pain - alleviation time were 90.3% and 7.8 months respectively. The hemorrhage control rate was 90.9% （ 10/11 ）. Quality of life was improved without any treatment related death. Conclusions Capecitabine and eisplatin combined with concurrent radiotherapy for recurrent cervical cancer is effective and well - tolerated in patients with pest - operatively local regionally recurrent or advanced cervical cancer.