紫杉醇脂质体联合铂类新辅助化疗对Ⅱa~Ⅳ期宫颈癌患者的近期疗效观察

Short-term curative effects of paclitaxel liposome combined with platinum in the treatment of stage Ⅱa to Ⅳ cervical cancer

目的观察紫杉醇脂质体联合顺铂新辅助化疗治疗Ⅱa~Ⅳ期宫颈癌的临床疗效和安全性。方法回顾性分析120例Ⅱa~Ⅳ期宫颈癌患者的临床资料,根据化疗方案不同将患者分为观察组(n=67)和对照组(n=53),观察组接受紫杉醇脂质体联合顺铂新辅助化疗治疗,对照组接受紫杉醇联合顺铂化疗治疗,两组均持续化疗2个疗程,期间均给予对症支持治疗。观察两组患者的近期疗效及不良反应发生情况,并对治疗前后两组患者的Karnofsky(KPS)功能状态评分进行比较。结果观察组和对照组患者的临床有效率分别为82.1%、77.4%,差异无统计学意义(P﹥0.05)。治疗后,两组患者的KPS评分均较本组治疗前明显提高(P﹤0.001);而观察组患者治疗后的KPS评分明显高于对照组治疗后(P﹤0.001)。观察组患者的肌肉酸痛、过敏反应总发生率均低于对照组(P﹤0.05);但两组骨髓抑制、胃肠道反应及脱发的总发生率比较,差异无统计学意义(P﹥0.05)。结论紫杉醇脂质体联合顺铂新辅助化疗对Ⅱa~Ⅳ期宫颈癌具有良好的疗效,相比于紫杉醇联合顺铂化疗,其耐受性更好,不良反应更轻。

Objective To observe the clinical effects and safety of paclitaxel liposome combined with platinum as adjuvant chemotherapy in the treatment of stage Ⅱa to Ⅳ cervical cancer. Method A retrospective analysis was performed for 120 patients with cervical cancer at stage IIa to IV. The patients were divided as study group（n=67） or control group（n=53） according to respective chemotherapy regimens. Patients in the study group were treated by paclitaxel liposome combined with platinum, while those in the control group were administered with paclitaxel plus platinum. The two groups were given 2 cycles of continuous chemotherapy, and concurrent symptomatic supportive treatment were administered for all patients. The clinical effects and safety of the two groups were evaluated, besides, the Karnofsky performance status（KPS） before and after treatment were compared. Result The response rate in study group and control group were 82.1% and 77.4%, respectively, with no significant difference observed（P〈0.05）. After treatment, the KPS scores improved obviously in the two groups（P〈0.001）; while the post-treatment KPS score in study group was significantly higher than that in control group（P〈0.001）. Lower total incidence of muscle soreness and anaphylaxis was observed in study group compared with control group（P〈0.05）. However, the total incidence of bone marrow suppression,gastrointestinal reactions and alopecia were similar between the two groups（P〈0.05）. Conclusion The chemotherapy regimens of paclitaxel liposome combined with platinum is clinically effective in the treatment of stage IIa to IV cervical cancer, with better tolerance and less adverse reactions compared with paclitaxel combined with platinum.