宫颈癌新辅助化疗药物的临床研究

Clinical Study of Neoadjuvant Chemotherapy Drugs for Cervical Cancer

目的:对比分析含奈达铂与含顺铂的TP方案在宫颈癌新辅助化疗中的疗效及不良反应。方法:81例Ⅰb2～Ⅱa期宫颈癌患者随机分为2组,A组(顺铂+多西他赛)40例、B组(奈达铂+多西他赛)41例,化疗1～2个疗程,比较2组疗效及不良反应。结果:在宫颈癌术前新辅助化疗中,2组疗效相当(其中A组总有效率为87.5%,B组总有效率为92.7%),2组差异无统计学意义(P>0.05);B组严重胃肠道反应(Ⅲ～Ⅳ度,发生率为0%)、重度骨髓抑制(Ⅲ～Ⅳ级,发生率为4.9%)的发生率明显低于A组(发生率分别为20.0%、15.0%),2组差异均有统计学意义(P<0.05);白细胞下降2组差异无统计学意义(P>0.05),血小板下降B组高于A组(P<0.05)。2组均未发现过敏反应、肝肾功能损害、神经毒性损伤、心功能异常。结论:在宫颈癌新辅助化疗中,奈达铂与顺铂疗效确切且相当,但是奈达铂与顺铂相比,不良反应轻、易耐受,可作为一线药物推荐。

OBJECTIVE： To analyze the therapeutic efficacy and adverse drug reaction of TP program containing nedaplatin and cisplatin as neoadjuvant chemotherapy for cervical cancer comparatively. METHODS： 81 cases of cervical cancer in Ⅰb2～Ⅱ a phase were randomly divided into 2 groups. 40 cases in group A （cisplatin＋docetaxel group） and 41 cases in group B （nedaplatin＋ docetaxel group） received 1～2 cycles of chemotherapy. The therapeutic efficacy and toxicity were compared between 2 groups. RE- SULTS： Therapeutic efficacy of neoadjuvant chemotherapy for cervical cancer before surgery in group A was similar to group B （the total effective rate： 87.5% for group A, 92.7% for group B）with no significant difference between the two groups （P〉 0.05）; The incidence of serious gastrointestinal reactions （Ⅲ～Ⅳ degrees, incidence rate of 0% ） and severe bone marrow suppression （ Ⅲ～Ⅳ grade, incidence rate of 4.9% ） in group B were significantly lower than group A （incidence rates of 20.0% and 15.0% ） （P〈0.05）. Leukopenia had no significant difference between the two groups （P〉0.05）. Thrombocytopenia of group B was higher than that of group A （P〈0.05）. The allergic reaction, liver and kidney dysfunction, neurotoxicity injury, heart dysfunction were not found in two groups. CONCLUSION： In neoadjuvant chemotherapy for cervical cancer, cisplatin vs. nedaplatin can achieve the same therapeutic efficacy. Nedaplatin can be recommended as the first-line drug for neoadjuvant chemotherapy with mild adverse drug reaction and good tolerance.