TP与PVB两种同步放化疗方案在维吾尔族中晚期宫颈癌的近期疗效比较

Clinical analysis of two different chemotherapy regimens for concurrent chemoradiotherapy in advanced cervical cancer for Uyghur women

目的：比较分析中晚期宫颈癌同步放化疗TP与PVB两种化疗方案的近期疗效及安全性。方法：回顾性分析新疆医科大学附属肿瘤医院2012年1月至2014年1月收治的接受同步放化疗的187例新疆维吾尔族宫颈癌中晚期患者（Ⅱb-Ⅳa期）,根据化疗方案不同分为两组：TP方案组104例、PVB方案组83例。治疗结束4周后进行疗效评价,比较两组的近期疗效和毒副反应。结果：近期疗效：两种治疗方案对于鳞癌的有效率分别为85.9%及73.5%,差异无统计学意义（P〉0.05）,对于非鳞癌（腺癌及腺鳞癌）的有效率分别为75.7%及40%,差异有统计学意义（P〈0.05）。毒副反应：骨髓抑制、周围神经毒性、胃肠道不良反应比较有统计学差异（P〈0.05）。肝肾功能损害、血细胞减少及放射性损伤无统计学意义（P〉0.05）。结论：对于宫颈鳞癌,两种同步放化疗近期疗效相当,对于非鳞癌,TP方案优于PVB方案。TP方案的骨髓抑制及神经毒性反应发生率明显高于PVB方案、胃肠道反应发生率则低于PVB方案。

Objective To compare theshort-term efficacy and safety between TP and PVB schemechemoradiation for advanced cervical cancer. Methods Between January 2012 and January 2014, 187 Xinjianguygur patients with advanced cervical cancer （stage I1 b to 1Va） who received concurrent chemoradiotherapy inXinjiang medical university affiliated tumor hospital were analyzed. All cases were divided into two groupsreceiving radiotherapy concomitant （n = 104）, PVB group （n = 83）. Theshort-term efficacy and toxicity wasevaluated four weeks aftertreatment. Results For squamous cell carcinomas, the response rates were 85.9% and73.5% in TP and PVB group respectively （P 〉 0.05）. For Non-squamous cell carcinomas （adenocarcinoma andadenosquamous）, the response rates were 75.7% and 40% in TP and PVB group respectively （P 〈 0.05）. B onemarrow suppression, neurotoxicity, gastrointestinal reactionwere significant different between two groups （P 〈0.05）. Liver and kidney functiondisorder, blood cellsreduction, and radiation damagewere not significantlydifferent （P 〉 0.05）. Conclusions For cervical squamous cell carcinomas, theshort-term efficacy of twochemotherapy regimens is similar while forNon-squamous cell carcinomas, TP regimengroup is superior toBonemarrow suppression and neurotoxicity in TP regimengroup is significantly higher than PVB group （P 〈 0.05）,while gastrointestinal adverse reaction lower than PVBgroup.