伊立替康联合顺铂和紫杉醇联合顺铂在宫颈癌新辅助化疗中的实效性和安全性评价

Effectiveness and safety evaluation of Irinotecan and paclitaxel in combination with cisplatin in neoadjuvant chemotherapy for cervical cancer

目的探究并评价伊立替康及紫杉醇分别与顺铂合用在宫颈癌新辅助化疗（NACT）中的实效性和安全性。方法选择2012年10月至2014年3月间接受NACT的宫颈癌患者84例,随机分为IP组和TP组各42例。IP组行伊立替康联合顺铂的化疗方案,TP组行紫杉醇联合顺铂的化疗方案,两组均在化疗结束后2~3周行手术治疗。对两组患者近期疗效进行评价,分析两组化疗后不良反应发生情况及术后病理检查结果。结果 IP组缓解率为47.6%（20/42）,TP组缓解率为81.0%（34/42）,两组差异有统计学意义（P〈0.05）。IP组腹泻和骨髓抑制发生率分别为76.2%（32/42）和57.1%（24/42）,TP组腹泻和骨髓抑制发生率分别为28.6%（12/42）和83.3%（35/42）,差异有统计学意义（P〈0.05）。术后病理检查显示,IP组宫旁累积率和淋巴结阳性率分别为33.3%（14/42）和30.9%（13/42）,TP组分别为19.0%（8/42）和14.3%（6/42）,差异有统计学意义（P〈0.05）。结论紫杉醇联合顺铂的化疗方案在宫颈癌NACT中有更加明显的优势。

Objective To explore and evaluate the effectiveness and safety of Irinotecan and paclitaxel in combination with cisplatin in neoadjuvant chemotherapy （NACT）for cervical cancer. Methods Eight-four women with cervical cancer accepted NACT in Maternal and Child Health Hospital of Tangshan from October 2012 to March 2014 were selected, and were randomly divided into the IP group and the TP group, each group with 42 cases. Patients in the IP group accepted Irinotecan and Cisplatin chemotherapy regimen （IP）, and the TP group accepted paclitaxel and Cisplatin chemotherapy regimen （TP）. All the patients accepted surgery at 2 - 3 weeks after NACT. The recent efficacy of the two groups was evaluated ; adverse reactions and pathological findings after NACT were recorded. Results Remission rate in IP group was 47.6% （20/42）, and TP group 81.0% （34/42）. The difference of the remission rate between the two groups was statistically significant （ P 〈 0. 05 ） ; The incidence of diarrhea and myelo suppression in IP group was 76. 2% （32/42） and 57. 1% （24/42） respectively, and was was 28.6% （12/42） and 83.3% （35/ 42） in TP group, respectively, and the difference was statistically significant （ P 〈 0. 05 ） ; Postoperative pathological examination showed that uterine accumulating rate and lymph node-positive rate in IP group was 33.3% （14/42）and 30.9% （13/42）respectively, and was 19.0% （8/42）and 14.3% （6/42）inTP group, the difference was statistically significant （P 〈 0. 05 ）. Conclusion Paclitaxel and cisplatin （TP） chemotherapy regimen has more obvious advantages in cervical cancer NACT.