多西他赛和紫杉醇分别联合顺铂用于局部晚期宫颈癌新辅助化疗的近期疗效观察

Short-term therapeutic effect of neoadjuvant chemotherapy with docetaxel or paclitaxel plus cisplatin before radical hysterectomy on locally advanced cervical cancer

目的探讨多西他赛(DTX)联合顺铂(DDP)与紫杉醇(TAX)联合DDP用于ⅠB2期—ⅡB期局部晚期宫颈癌(LACC)患者术前新辅助化疗(NACT)的近期疗效与不良反应。方法回顾性分析经组织病理学活检确诊为ⅠB2期—ⅡB期宫颈癌的106例患者。分为DP组(n=54,DTX 75 mg/m^2+DDP 75 mg/m^2)和TP组(n=52,TAX 135 mg/m^2DDP 75 mg/m^2),两组均在宫颈癌根治术前给予2次NACT,比较效果、毒副反应及术后切除标本的病理结果。结果 DP组化疗后有效率为90.7%,TP组的化疗有效率为84.6%,两者比较差异无显著性(P>0.05)。DP组白细胞减少明显低于TP组,差异具有显著性(P<0.05),两组间Hb减少,差异无显著性(P>0.05);DP组神经毒性反应、胃肠道反应较TP组轻,差异有显著性(P<0.05),两组间脱发、肝肾脏毒性反应差异无显著性(P>0.05)。两组术后标本病理组织检查,完全缓解率和理想的病理反应率及宫旁浸润、盆腔淋巴结阳性率等方面比较,差异均无显著性(P>0.05)。结论 DTX+DDP方案与TAX+DDP方案在宫颈癌NACT的近期效果相近,但DTX+DDP方案的不良反应较轻,值得推荐。

Objective To investigate the efficacy and adverse reactions of neoadjuvant chemotherapy of docetaxel（DTX） or paclitaxel（TAX） plus cisplatin（DDP） before radical hysterectomy on patients with stageⅠB2-ⅡB locally advanced cervicalcancer. Methods 106 patients with stage ⅠB2-ⅡB cervical cancer who were treated with different chemotherapy regimens were retrospectively analyzed. The patients were divided into DP group（n=54,DTX 75 mg /m^2＋ DDP 75 mg /m^2）and TP group（n=52,TAX 135 mg /m^2＋ DDP75 mg /m^2）. All of the patients were given two cycles of neoadjuvant chemotherapy. The efficacy, side effects of neoadjuvant chemotherapy and pathological examination after hysterectomy were compared between two groups. Results There was no significant difference in chemotherapy efficacy between the two groups（90.7% vs 84.6%,P〈0.05）. The side effects of neoadjuvant chemotherapy： the incidence of leucopenia in DP group were lower than that in TP group（P〈0.05）. There were no significant differences in hemoglobin,alopecia, hepatic renal toxicity between two groups（P〈0.05）. The gastroenteric and neurotoxicity reactions in DP group were lower than those in TP group（P〈0.05）. There were no significant difference（P〈0.05） between two groups in pathological complete remission rate, ideal pathological response rate, parametrial invasion, positive rate of pelvic lymph nodes etc（P〈0.05）. Conclusion The neoadjuvant chemotherapy of both DTX or TAX plus DDP have similar efficacy in the treatment of locally advanced cervical cancer,and the adverse reactions of DTX plus DDP is mild, is worth to be recommended in locally advanced cervical cancer.