紫杉醇联合顺铂或奈达铂新辅助化疗治疗局部晚期子宫颈癌的近远期疗效观察

Response of neoadjuvant chemotherapy with paclitaxel combined with cisplatin or with nadaplatin in the treatment for locally advanced cervical cancer

目的比较紫杉醇联合顺铂或奈达铂新辅助化疗治疗局部晚期子宫颈癌的疗效和不良反应。方法49例局部晚期子宫颈癌患者随机分为顺铂组和奈达铂组,给予紫杉醇联合顺铂或奈达铂化疗,化疗2个疗程。评价两组的近、远期疗效和不良反应。结果顺铂组总缓解率为79.2%,临床获益率为100.0%,奈达铂组总缓解率为76.0%,临床获益率为100.0%。两组比较差异均无统计学意义(P>0.05)。各组化疗前后肿瘤大小比较差异均具有统计学意义(P<0.05),但两组组间比较差异无统计学意义(P>0.05)。顺铂组Ⅰ、Ⅱ级胃肠道反应、肌酐升高和血红蛋白下降的发生率明显高于奈达铂组(P<0.05),但其Ⅰ、Ⅱ级血小板减少的发生率明显低于奈达铂组(P<0.05)。顺铂组1、2、3年生存率分别为91.7%、83.3%和79.2%,奈达铂组1、2、3年生存率分别为88.0%、84.0%和76.0%,两组比较差异均无统计学意义(P>0.05)。结论紫杉醇联合顺铂或奈达铂新辅助化疗治疗局部晚期子宫颈癌患者的近、远期疗效相似,但奈达铂不良反应相对低,临床更易耐受。

Objective To compare the efficacy and safety of paclitaxel plus cisplatin or nadaplatin on locally advance cervical carcinoma. Methods Forty-nine cases of locally advanced cervical carcinoma were randomly divided into cisplatin group （paclitaxel plus cisplatin） and nadaplatin group （paclitaxel plus nadaplatin）. Both groups were treated with the corresponding regimes for 2 courses. The short-term and long-term efficacy and toxicity were evaluated. Results No significant difference in total response rate and clinical benefit rate was observed between cisplatin and nadaplatin groups （79.2% vs 76.0% ; 100.0% vs 100.0% ; both P 〉 0.05）. Tumor size decreased after chemotherapy in both groups （P 〈 0.05）, but the change in two groups was similar （ P 〉 0.05 ）. Adverse reactions, including I ~ I~ degree gastrointestinal adverse reaction, creatinine elevation and decrease of hemoglobin level, were tbund more in cisplatin group than those in nadaplatin group （ P 〈 0.05 ）, but the rate of thrombocytopenia was relatively lower in cisplatin group （ P 〈 0.05 ）. No significant difference was found in 1, 2 and 3-year survival rates between cisplatin group and nadaplatin group （91.7%, 83.3% and 79.2% vs 88.0%, 84.0% and 76.0% ;P 〉 0.05 ）. Conclusions The short-term and longterm efficacy of paclitaxel plus cisplatin or nadaplatin on locally advanced cervical carcinoma are similar, but nadaplatin has less adverse reactions and is more tolerable.