紫杉醇联合奈达铂同期放化疗及巩固化疗治疗局部晚期宫颈癌的临床研究

Clinical study on treating locally advanced cervical cancer by paclitaxel combined with nedaplatin chemoradiotherapy and adjuvant chemotherapy

目的探究对于局部晚期宫颈癌患者应用紫杉醇联合奈达铂同期放化疗及巩固化疗的临床效果。方法对52例局部晚期宫颈癌患者使用高剂量率腔内后装联合盆腔外照射,结合患者病理分期,确定照射剂量,同时进行化疗,方案为60 mg/m^2奈达铂联合135 mg/m^2紫杉醇1次/月,巩固治疗方案为:60 mg/m^2奈达铂联合135 mg/m^2紫杉醇。对比治疗效果和不良反应。结果完全缓解39例,部分缓解13例。经巩固化疗之后庑全缓解者为45例,占总数的86.54%;部分缓解者为7例,占总数的13.46%。巩固与同期放化疗出现Ⅲ级血液学毒性反应的人数分别为5例和1例,1例患者出现腹泻。同期放化疗内,12例出现Ⅲ级WBC和中性粒细胞下降现象。3例患者为Ⅲ级晚期大肠癌反应。结论对于局部晚期宫颈癌患者,实施紫杉醇联合奈达铂同期放化疗及巩固化疗法实施临床治疗患者不良反应少,依从性佳治疗效果好,值得进一步推广。

Objective To explore the clinical effect of paclitaxel combined with nedaplatin chemoradiotherapy and consolidation chemotherapy for locally advanced cervical cancer. Methods 52 cases of patients with locally advanced cervical cancer using high dose rate intracavitary packing combination pelvic external exposure, combined with the pathological staging of patients to determine the exposure dose, at the same time, the implemented chemotherapy. The scheme was 60mg/m2 of nedaplatin combined with 135 mg/m2 paclitaxel, and the scheme used 1 time a month, consolidating treatment scheme was 60 mg/m2 of nedaplatin combined with 135 mg/m2 paclitaxel. Compare the treatment effect and adverse reactions. Results Complete remission in 39 cases, partial remission in 13 cases. After consolidate chemotherapy, complete remission in 45 cases, which accounting for 86.54%. Partial remission in 7 cases, accounted for 13.46% of the total number. During consolidation chemotherapy and chemoradiotherapy, the number of level Ⅲ hematology toxicity in 5 cases and 1 case respectively, 1 case of patients with diarrhea. Within the chemoradiotherapy, WBC and neutrophil level Ⅲ decline phenomenon occurred in 12 cases. Three patients performed level Ⅲ advanced colorectal cancer reaction. Conclusions For patients with locally advanced cervical cancer, the implementation of Nedaplatin combined with paclitaxel ehemoradiotherapy and consolidation therapy for clinical treatment, patients will suffering less adverse reaction, perform good compliance and will obtain good treatment effect, it is worthy of further promotion.