紫杉醇或多西他赛联合奈达铂在宫颈癌新辅助化疗中的疗效及安全性

The efficacy and safety of paclitaxel or docetaxel combined with nedaplatin in the neoadjuvant chemotherapy of cervical cancer

目的:评价紫杉醇或多西他赛分别联合奈达铂用于Ⅰb2~Ⅱb期宫颈癌病人行根治术前新辅助化疗的疗效及安全性。方法:选择经病理确诊的48例Ⅰb2~Ⅱb期宫颈癌病人作为研究对象,根据化疗方案不同分为紫杉醇+奈达铂组24例,多西他赛+奈达铂组24例,分别于根治性子宫切除术前/根治性放疗前行辅助化疗1个周期,比较2种化疗方案的疗效和不良反应。结果:紫杉醇+奈达铂组总有效率和多西他赛+奈达铂组总有效率分别为83.33%和79.17%,差异无统计学意义(P>0.05);紫杉醇+奈达铂组完全缓解率(29.17%)高于多西他赛+奈达铂组(16.67%),但差异无统计学意义(P>0.05);2组手术切除率均为100%,紫杉醇+奈达铂组术后病理不良预后高危因素发生率为33.33%,多西他赛+奈达铂组为16.67%;紫杉醇+奈达铂组术后3年无瘤生存率和3年总生存率分别为91.67%和95.83%,多西他赛+奈达铂组分别为87.50%和95.83%,2组差异均无统计学意义(P>0.05);2组化疗不良反应总发生率差异无统计学意义(P>0.05)。结论:紫杉醇或多西他赛分别联合奈达铂用于Ⅰb2~Ⅱb期宫颈癌术前新辅助化疗安全有效,2种化疗方案疗效相近,不良反应相似,病人均可以耐受。

Objective：To evaluate the efficacy and safety of the neoadjuvant chemotherapy of paclitaxel or docetaxel combined with nedaplatin in stage Ⅰb2~Ⅱb cervical cancer. Methods：A total of 48 patients with stageⅠb2 ~Ⅱb cervical cancer diagnosed by pathology were investigated,and divided into the paclitaxel plus nedaplatin group and docetaxel plus nedaplatin group（24 cases each group） . The paclitaxel plus nedaplatin group and docetaxel plus nedaplatin group were treated with neoadjuvant chemotherapy for 1 cycle before radical hysterectomy and radical radiation therapy,respectively. The clinical effect and adverse reaction between two groups were compared. Results：The total effective rates in paclitaxel plus nedaplatin group and docetaxel plus nedaplatin group were 83. 33%and 79.17%,respectively,and the difference of which was not statistically significant（P 〉0. 05）. The complete remission rates in paclitaxel plus nedaplatin group and docetaxel plus nedaplatin group were 29. 17% and 16. 67%,respectively,and the difference of which was not statistically significant（P〉0. 05）. The excision rate in two groups was 100%. The incidence rates of high risk factors of postoperative adverse prognosis in paclitaxel plus nedaplatin group and docetaxel plus nedaplatin group were 33. 33% and 16. 67%, respectively. The 3-year free tumor survival rates and overall survival rates in paclitaxel plus nedaplatin group and docetaxel plus nedaplatin group were 91. 67% ＆amp;95. 83% and 87. 50% ＆amp;95. 83%,respectively,and the differences of which were not statistically significant（P〉0. 05）. The difference of the total incidence rate of adverse reaction between two groups was not statistically significant （P〉0. 05）. Conclusions：The neoadjuvant chemotherapy of paclitaxel or docetaxel combined with nedaplatin in stage Ⅰb2 ~Ⅱb cervical cancer is safe and effective. The clinical effect and adverse reaction of two methods are similar,and patients can tolerate.