三维适形放疗同步多西他赛与顺铂治疗局部晚期宫颈癌的临床研究

3DCRT with Docetaxel versus with Cisplatin: Two Synchronization Thera-pies for Locally Advanced Cervical Cancer

目的通过比较三维适形放疗(3DCRT)同步多西他赛与同步顺铂方案治疗局部晚期宫颈癌患者的疗效和不良反应,探讨其最佳的治疗方法。方法回顾性研究永州市中心医院2009年1月—2012年12月收治的80例局部晚期宫颈癌(IIBIVA期)患者的临床资料。将上述病例分为D组和P组,其中D组共42例为放疗同步多西他赛,具体方法为放疗期间接受多西他赛35 mg/m2,每周1次;P组共38例为3DCRT同步顺铂,具体方法为放疗期间接受顺铂40 mg/m2,每周一次。两组放疗总剂量CTV 50Gy,GTV 70-75Gy。治疗期间和治疗结束后观察两组患者出现的不良反应及疗效。结果两组治疗有效率分别为95.2%、73.6%;3年生存率分别为92.8%、60.5%,D组优于P组,且差异有统计学意义(P<0.05);急性血液毒性发生率分别为95.2%、94.7%;胃肠道毒性发生率分别为85.7%、89.5%,差异无统计学意义(P>0.05)。结论三维适形放疗同步多西他赛疗效优于同步顺铂方案,毒副反应相当,可作为治疗局部晚期宫颈癌患者的首选方案。

Objective To explore the best procedure for treatment of locally advanced cervical cancer by comparing the efficacy and adverse reaction between 3DCRT combined with docetaxel and 3DCRT combined with cisplatin. Methods The clinical data of80 patients with locally advanced cervical cancer admitted in the Yongzhou Central Hospital between January 2009 and December2012 was retrospectively studied. All the patients were divided into D group in which 42 patients were treated with synchronization therapy of 3DCRT and weekly intravenous drip of 35mg/m^2 docetaxel, and P group in which 38 patients underwent synchronization therapy of 3DCRT and weekly intravenous drip of 40mg/m^2 cisplatin. The total dose of radiotherapy of the two groups was CTV50 Gy and GTV 70-75 Gy. The adverse reaction and treatment efficiency of the two groups were observed. Results The treatment efficiency of the two groups were 95.2% and 73.6% and 3-year-survival rate 92.8% and 60.5% respectively, therefore the D group was better than the P group, and the difference was statistically significant（P〈0.05）; the incidence of acute blood toxicity of the two groups were 95.2% and 94.7% and incidence of gastrointestinal toxicity 85.7% and 89.5%, and the differences were not statistically significant（P〈0.05）. Conclusion In the treatment of patients with locally advanced cervical cancer, except for equivalent adverse reaction, the effect of 3DCRT combined with docetaxel is superior to that of 3DCRT combined with cisplatin, therefore it should be taken as the first scheme.