周疗在宫颈癌同步放化疗中的作用

The efficient of chemotherapy weekly in the chemoradiotherapy of cervical cancer

目的评价周疗在宫颈鳞癌同步放化疗中的作用。方法对该院2003年1月至2007年10月收治的Ⅲb期宫颈鳞癌168例分为两组,其中观察组86例采用紫杉醇+顺铂周疗+同步放疗,对照组82例采用紫杉醇+顺铂3周疗法+同步放疗,比较两组的5年生存率和不良反应。结果观察组5年生存率为52.3%(45/86),对照组为42.7%(35/82),两组比较差异无统计学意义(P>0.05);观察组有效率(CR+PR)为94.2%(81/86),对照组为92.7%(76/82),两组比较差异无统计学意义(P>0.05);观察组Ⅲ度以上骨髓抑制发生率为9.3%(8/86),对照组为20.7%(17/82),两组比较差异有统计学意义(P<0.05);观察组Ⅲ度以上胃肠道反应发生率为8.1%(7/86),对照组为19.5%(16/82),两组比较差异有统计学意义(P<0.05);观察组放疗完成时间(54.72±4.76)d,对照组(61.12±6.71)d,两组比较差异有统计学意义(P<0.05)。结论宫颈鳞癌同步放化疗中周疗较3周疗法疗效不良反应更少,疗效相当。

Objective To evaluate the clinical efficacy and safety of chemotherapy weekly in the chemoradiotherapy of cervical cancer.Methods Between Jan 2003 and Oct 2007,168 patients with stage ⅢB squamous cell carcinoma of the uterine cervix in Chongqing Cancer Hospital were divided into two groups randomly.The observation group,total 86 patients receiving radiotherapy concomitant with weekly cisplatin and taxol;the matched group,total 82 patients,receiving radiotherapy concomitant with cisplatin plus taxol every 3weeks.There were no statistical difference in the clinical and pathological characteristics between the two groups.We compare the 5years survival rate and side reaction of the two groups.Results The 5years survival rate of the observation group and the matched group were respectively 52.3%（45/86）and 42.7%（35/82）,in which there was no significant difference（P〈0.05）.The response rate（CR＋PR）were respectively 94.2%（81/86）and 92.7%（76/82）in the observation group and the matched group,in which there was no significant difference（P〈0.05）.GradeⅢ acute gastrointestinal toxicities（nausea and vomiting）in the matched group were exactly higher than that in the observation group [19.5%（16/82）vs.8.1%（7/86）,P〉0.05].Moreover,GradeⅢ myelosuppression in the matched group were exactly higher than that in the observation group[20.7%（17/82）vs.9.3%（8/86）,P〉0.05].there were no significant difference of the incidence of the radiocystitis,radiation proctitis and radiodermatitis between the two groups.But the Radiotherapy completion time in the matched group were exactly longer than that in the observation group[（61.12±6.71）days vs.（54.72±4.76）days,P〈0.05].Conclusion The toxicity of the observation group was lower than the matched group.Moreover the efficacy of observation group is similar to the matched group.