脂质体紫杉醇联合顺铂对晚期宫颈癌术前化疗的疗效观察

Efficacy of paclitaxel combined with cisplatin chemotherapy for patients with locally advanced cervical cancer

目的探讨脂质体紫杉醇联合顺铂用于治疗局部晚期宫颈癌患者的临床疗效和不良反应。方法选择2005年5月至2009年5月我院收治的局部晚期宫颈癌患者78例,按就诊顺序将患者分为顺铂联合5-氟尿嘧啶组(PF组,39例)和脂质体紫杉醇联合顺铂组(Taoxl组,39例)。PF组患者采用顺铂联合5-氟尿嘧啶化疗方案,Taxol组患者采用脂质体紫杉醇联合顺铂化疗方案。2组患者化疗后均全麻下行广泛子宫切除术和盆腔淋巴结清扫术,评价并比较2组患者的临床疗效、不良反应和术后3年生存率。结果 PF组患者不良反应主要为消化道反应、口腔黏膜炎和骨髓抑制,Taxol组患者的不良反应主要有骨髓抑制、口腔黏膜炎和肾脏毒性。Taxol组患者的化疗后完全缓解率30.77%,高于PF组的10.26%(χ2=5.032,P=0.025)。Taxol组和PF组患者平均生存时间分别是33.5个月和34.7个月,3年生存率分别为59.6%和70.2%,差异无统计学意义(χ2=1.859,P=0.173)。结论 2种化疗方案患者不良反应差别较大,脂质体紫杉醇联合顺铂化疗方案临床疗效优于顺铂联合5-Fu化疗方案。

Objective To explore the clinical efficacy and side effects of paclitaxel combined with cisplatin chemotherapy for patients with locally advanced cervical cancer. Methods From May 2008 to May 2009,78 patients with locally advanced cervical cancer in our hos-pital were randomly divided into PF group （39 cases） and Taxol group （39 cases）. Patients from PF group were treated with cisplatin com-bined 5-Fu while patients in Taxol group were cured with paclitaxel combined with cisplatin. After chemotherapy,all patients were given anes-thesia extensive hysterectomy and pelvic lymph node dissection. The clinical efficacy,side effects and three-year survival of 2 groups were as-sessed and compared. Results The main adverse reactions of PF group were gastrointestinal reactions,oral mucositis and bone marrow sup-pression;the major side effects of Taxol group were bone marrow suppression,oral mucositis and renal toxicity. After chemotherapy,the com-plete remission rate of Taxol group reached 30. 77%,which was higher than that of PF group 10. 26% （χ2 =5. 032,P=0. 025）. The average survival time of PF group and Taxol group were 33. 5 months and 34. 7 months,the three-year survival were 59. 6% and 70. 2%,respectively （χ2 =1. 859,P=0. 173）,and the difference was not statistically significant. Conclusion The adverse effects of different chemotherapy were observed in 2 groups. The clinical efficacy of Taxol group were better than that of PF group.