洛铂化学治疗同步调强放射治疗应用于局部晚期宫颈癌的临床观察

Concurrent lobaplatin-based intensity-modulated radiotherapy and chemotherapy for locally advanced cervical carcinoma

目的比较洛铂与顺铂化学治疗同步调强放射治疗应用于局部晚期宫颈癌的近期疗效和不良反应的发生情况。方法连续纳入国际妇产科联盟(FIGO)分期为ⅡB至ⅢB期的宫颈癌患者78例,年龄23~78岁,将其随机分为洛铂组和顺铂组,每组39例。均采用盆腔外照射加腔内后装放射治疗,从放射治疗第1周起,洛铂组与顺铂组每周分别用洛铂10mg/m^2与顺铂30mg/m^2静脉滴注,共6周,比较两组患者的近期疗效和急性不良反应发生情况。结果放射治疗结束后3个月,两组患者有效率均达100.0%,两组间的差异无统计学意义(P>0.05)。洛铂组的恶心呕吐发生率为38.5%(15/39),显著低于顺铂组的100.0%(39/39,P<0.01);洛铂组的耳毒性发生率为0,显著低于顺铂组的10.3%(4/39,P<0.05)。两组间其他急性不良反应发生率的差异均无统计学意义(P值均>0.05)。结论同步调强放射治疗应用于局部晚期宫颈癌时,洛铂与顺铂化学治疗的近期疗效相似,但洛铂的胃肠道反应少,无耳毒性,患者耐受性好。

Objective To explore the short-term outcomes and adverse effects of concurrent Iobaplatinbased versus cisplatin-based intensity-modulated radiotherapy （IMRT） and chemotherapy for locally advanced cervical cancer. Methods Seventy-eight patients with cervical cancer, who were staged by the International Federation of Gynecology and Obstetrics （FIGO） staging systems to be at stage III B-- III B and aged between 23- 78 years old, were consecutively recruited in this study. They were evenly divided into Iobaplatin group and ciplatin group at random （n = 39）. Patients in both groups were treated with external pelvic radiation in combination with after-loading therapy in the pelvic cavity. One week after radiotherapy, the patients were intravenously administered with 10 mg/m^2 Iobaplatin and 30 mg/m^2 , respectively, once a week for a total of 6 weeks, The short-term efficacy and acute adverse reactions were compared between the two groups, Results The effective rates were 100. 0% in both groups 3 months after radiotherapy-, and there was no significant difference between groups （P〉0. 05）. The incidence of nausea and vomiting was 38. 5% （15/39） in the Iobaplatin group, which was significantly lower than that in the ciplatin group （100.0%, 39/39, P〈0. 01）. The incidence of ototoxicity was 0 in the Iobaplatin group which was also significantly lower than that in the ciplatin group （10.3%, 4/39, P〈0.05）. There were no significant differences in other acute adverse reactions between the two groups （all P 〉0. 05）. Conclusion The short-term outcome of Iobaplatin-based concurrent radiochemotherapy is similar to that of cisplatin-based one for locally advanced cervical cancer. But there are less gastrointestinal reactions, no ototoxicity and better tolerance in patients treated with Iobaplatin.