奈达铂和顺铂在局部晚期宫颈癌患者同步放化疗疗效比较

The comparison of efficacy of cisplatin and nedaplatin for concurrent chemoradiotherapy for patients with locallyadvanced cervical cancer

目的 通过比较奈达铂或顺铂同步放化疗治疗对局部晚期宫颈癌患者的作用,探析上述两种药物的临床疗效.方法 分析2009年2月至2011年11月在本院接受治疗的54例局部晚期宫颈癌患者的临床资料.按随机数字表法将入选者分为DDP组（顺铂组）和NDP组（奈达铂组）两组,每组27例.比较两组患者的基线资料、近期疗效、远期疗效以及不良反应.结果 两组患者的一般资料包括性别、年龄、BMI、分期、病理比较差异均无统计学意义（P＞0.05）.两组的有效率（RR）均为100％,其中NDP组的完全缓解（CR）率（74.1％）与DDP组（63.0％）比较差异无统计学意义（P＞0.05）.两组≤60岁的患者中,CR率、1、2、3年的生存率、中位无进展生存期（PFS）比较差异均无统计学意义（P＞0.05）;＞60岁患者中,1、2、3年的生存率、中位PFS比较差异均无统计学意义（P＞0.05）,但是两组的CR率比较差异有统计学意义（P＜0.05）.在非血液学毒性上,NDP组发生恶心呕吐的几率、对于肾功能的影响明显比DDP组低（P＜0.05）;两组在肝功能受损上差异无统计学意义（P＞0.05）.在血液学毒性上,两组患者在贫血和白细胞下降发生率方面差异无统计学意义（P＞0.05）;NDP组发生血小板下降的几率明显比DDP组高（P＜0.01）,但是其主要体现在Ⅰ、Ⅱ级.结论 对于局部晚期宫颈癌的治疗,单药奈达铂与单药顺铂的同步放化疗的疗效相近,且顺铂的耐受性不及奈达铂。

Objective To investigate the clinical effect of cisplatin and nedaplatin through comparing the effects of synchronous radiotherapy and chemotherapy of cisplatin and nedaplatin on patients with locally advanced cervical cancers.Methods Clinical data of 54 cases of patients with locally advanced cervical cancers received treatment at our hospital from 2009 to 2011 were analyzed retrospectively.Patients were divided into two groups according to the treatment：group DDP （cisplatin） and group NDP （nedaplatin）.The general information,short-term effect,long-term curative effect,and adverse reactions were compared between two groups.Results The general information including gender,age,body mass index （BMI）,stages,and pathology had no statistically significant difference between two groups.The response rate （RR）of patients in each group was 100%.The complete remission （CR） rate between groups NDP and DDP had no statistically significant difference.Among the patients ≤60 years old,the CR rate,the survival rate of 1,2,and 3 years,and the median progression-free survival （PFS） had no statistically significant difference.Among the patients 〉 60 years old,the survival rate of 1,2,and 3 years,and the median PFS had no statistically significant difference,but the CR rate had statistically significant difference.In the non-hematological toxicity,the incidence rate of nausea and vomiting,the effect on renal function in group NDP were obviously lower than those in group DDP.There was no significant difference in liver function damage.In the hematological toxicity,there was no statistically significant difference in the incidence rate of anemia and leukopenia.The incidence rate of decrease of platelet in group NDP was higher than that in group DDP,but it was mainly reflected in the Ⅰ and the Ⅱ level.Conclusions Cisplatin had the same efficacy of concurrent chemoradiotherapy with nedaplatin for the treatment of locally advanced cervical carcinoma with a worse tolerance.