多西他赛与奈达铂方案在局部晚期宫颈癌新辅助化疗中的临床观察

Clinical study of docetaxel and nadaplatin in the neoadjuvant chemotherapy for local advanced cervical cancer

目的评价多西他赛和奈达铂方案在局部晚期宫颈癌新辅助化疗中的疗效和毒性反应。方法89例Ⅰb2～Ⅱa期宫颈癌患者随机分成实验组48例和对照组41例。实验组采用多西他赛＋奈达铂方案化疗，多西他赛70—75mg／m^2，第1天，奈达铂70～80mg／m2，第1天，共2疗程，间隔21天。对照组采用多西他赛＋DDP方案化疗，多西他赛70-75mg／m2，第1天，DDP60—75mg／m^2，分2天滴注，2疗程，间隔21天。新辅助化疗2疗程后根据妇科检查及cT检查结果判断，肿瘤有效缩小者行根治性手术，效果不佳者行根治性放疗。结果实验组化疗有效率为83．3％，对照组化疗有效率为85．3％，差异无显著性（P〉0．05）实验组Ⅲ。Ⅳ度白细胞减少发生率低于对照组（P〈0．05），呕吐反应也少于对照组（P〈0．05）。结论多西他赛＋奈达铂方案在局部晚期宫颈癌新辅助化疗中近期疗效与多西他赛＋奈达铂方案相当，但化疗急性毒性反应明显减少，患者更容易耐受。

] Objective To evaluate the clinical curative effect and toxicity of docetaxel and nadaplatin in the neoadjuvant chemotherapy for local advanced cervical cancer. Methods 89 cases of local advanced cervical cancer were randomly divided into study group（n = 48） and control group（n = 41）. The patients in study group received 2 cycles docetaxel and nadaplatin（docetaxe170-75 mg/m2 d 1, nadaplatin 70-80 mg/m2 dl）. The patients in control group were treated with 2 cycles docetaxel and DDP（docetaxe170- 75 mg/m2 dl, DDP 60-75 mg/m2 dl, d2）. After the CT scan and physical examination, tumor effectively reducing patients received radical surgery, others received radical radiation. Results The chemotherapy response rate was 83.3% in study group, and 85.3% in control group, there was no significant difference between two groups（P〉 0.05）. The incidence of acute bone marrow inhibition in study group was lower than that in control group（P〈 0.05）, gastrointestinal reaction in study group was also significantly lower than that in control group（P〈 0.05）. Conclusions Docetaxel and nadaplatin in the neoadjuvant chemotherapy for local advanced cervical cancer has similar response rate to the regimen of docetaxel and DDP, while the acute toxicity of patients is obviously decreased.