两种化疗方案治疗宫颈癌不良反应临床分析

Clinical analysis of adverse reactions of two regimens in the treatment of cervical cancer

目的对比分析含奈达铂(NDP)和含顺铂(DDP)的TP方案在宫颈癌新辅助化疗中的药物不良反应。方法将80例Ib2～IIa期宫颈鳞状细胞癌患者随机分为2组,A组(顺铂+多西他赛组)40例、B组(奈达铂十多西他赛组)40例,采用1～2个疗程化疗,比较其毒副反应。结果 B组严重胃肠道反应(III～IV度,发生率为4.0%)、重度骨髓抑制(III～IV级,发生率为5.0%)发生率明显低于A组(发生率分别为20%、20%)(P<0.05),B组肾功能损害发生率低于A组(P<0.05),白细胞下降两组差异无显著性(P>0.05),但B组血小板下降程度高于A组(P<0.05),两组均未发现由铂类所引起的过敏反应、肝功能损害、神经毒性损伤、心脏功能异常。结论在宫颈癌新辅助化疗中奈达铂与顺铂相比,药物不良反应轻,较少引起严重的胃肠道反应、重度骨髓抑制及肾功能损害,易耐受,可联合紫杉类药物作为宫颈癌新辅助化疗的一线药物推荐。

Objective： To make comparative analysis of containing nedaplatin（NDP） and cisplatin（DDP） TP reginmen neoadjuvant chemotherapy in cervical cancer of adverse drug reactions.Methods： Eighty patients with stage Ib2~IIa squamous cell carcinoma of the cervix were randomly divided into 2 groups,with 40 cases in Group A（cisplatin plus docetaxel group）,and 40 cases in Group B（nedaplatin plus docetaxelgroup）,using the l^2 courses of chemotherapy,and their toxicity was compared.Results： The serious gastrointestinal reaction（III^IV degrees,the incidence rate of 4.0%）,severe bone marrow suppression（III^IV levels,the incidence rate of 5.0%） in the B group of was significantly lower than those in the A group（occurrence rates were respectively 20% and 20%）（P0.05）,but platelet decrease in Group B was higher than that in Group A（P〈0.05）.The platinum-induced allergic reaction,liver dysfunction,neurotoxicity injury,heart dysfunction were not found in the two groups.Conclusion： Neoadjuvant chemotherapy in cervical cancer of cisplatin,compared with nedaplatin,has less adverse drug reaction to light,and is less likely to cause severe gastrointestinal reaction,severe bone marrow suppression and renal dysfunction,and well tolerated,which can be recommended as drugs in combination with paclitaxel as a neoadjuvant chemotherapy of cervieal cancer.