不同化疗方案对宫颈癌患者卵巢功能的影响

Effect of different chemotherapy regimens on ovarian function in patients with cervical cancer

目的探讨不同化疗方案对宫颈癌患者卵巢功能的影响。方法选取2013年6月至2014年10月间山东省枣庄市山亭区人民医院收治的宫颈癌患者88例为研究对象,所有患者均行手术治疗,手术后局部放疗。根据术后化疗方案不同分为观察组和对照组,每组44例。观察组患者术后给予吡柔比星+替加氟+亚叶酸钙+异环磷酰胺(CAF方案)治疗,对照组患者术后给予多西他赛+吡柔比星+异环磷酰胺(DTC方案)治疗,比较两组患者化疗后月经状况和化疗前、化疗后6个月和12个月时的卵巢功能状况。结果观察组患者手术后化疗致闭经(CIA)的发生率显著低于对照组,且CIA恢复率显著高于对照组,恢复时间显著低于对照组,差异均有统计学意义(均P<0.05)。化疗前两组患者的各项卵巢激素水平比较无统计学意义,化疗后6个月、12个月对照组患者激素水平改变均显著大于观察组患者,差异均有统计学意义(均P<0.05)。结论宫颈癌患者术后用CAF方案化疗,对患者的卵巢功能影响较小,CIA发生率低,恢复好,值得临床推广应用。

Objective To explore the effect of different chemotherapy regimens on ovarian function in patients with cervical cancer. Methods The study selected 88 patients with cervical cancer treated at Shanting District People’s Hospital as research subjects between June 2013 to October 2014. All patients underwent surgery and postoperative partial radiotherapy. According to different chemotherapy regimens,patients were divided into an observation group and a control group with 44 patients in each group. After the surgery,patients in the observation group were given CAF regimen（ pirarubicin ＋ tegafur ＋ leucovorin ＋ifosfamide）,and patients in the control group were given DTC regimen（ docetaxel ＋ pirarubicin ＋ ifosfamide）. Menstrual status were compared after chemotherapy and ovarian function was compared before chemotherapy and at 6 and 12 months after chemotherapy respectively between the two groups. Results In the observation group,the incidence of postoperative chemotherapy-induced amenorrhea（ CIA） was significantly lower,recovery rate of CIA was significantly higher,and recovery time was significantly lower compared with the control group（ P 〈 0. 05）. There was no significant difference in ovarian hormone levels before chemotherapy. Change in hormone levels in the control group was significantly higher than in the observation group at 6 and 12 months after chemotherapy（ P 〈 0. 05）. Conclusion CAF chemotherapy has less effect on ovarian function in patients with cervical cancer after surgery with low incidence of CIA and well recovery,which is worthy of promotion and application in clinical practice.