紫杉醇联合洛铂治疗LACC患者的疗效评价

Efficacy Evaluation of Paclitaxel Combined with Platinum on Patients with LACC Chemotherapy

为了探讨紫杉醇联合洛铂在局部晚期宫颈癌(LACC)患者术前新辅助化疗中的效果以及对患者血清肿瘤标记物和预后的影响。本研究选取在我院实施新辅助化疗的58例LACC患者进行研究,其中29例患者采用紫杉醇联合洛铂新辅助化疗方案(A组)、29例患者采用紫杉醇联合顺铂治疗(B组),两组患者均实施根治性宫颈癌手术治疗,对比两组患者的近期疗效、血清肿瘤标记物、毒副反应发生率及远期预后。研究发现,A组患者的缓解率82.75%、总有效率100%,B组患者的缓解率68.97%、总有效率96.55%,两组间比较差异均不具有统计学意义(p>0.05);化疗后,A组和B组患者的血清CYFRA21-1、SCCAg水平较化疗前均显著的降低(p<0.05);化疗过程中,A组患者的恶心呕吐、腹泻发生率分别为17.24%、6.90%,B组患者的恶心呕吐、腹泻发生率分别为48.28%、62.07%,两组比较差异具有统计学意义(p<0.05);36个月随访,A组总生存率为68.97%(20/29)、B组患者的总生存率为62.07%(18/29),两组比较差异无统计学意义(χ~2=0.305,p=0.581>0.05);两组患者的生存函数曲线分析,生存时间比较差异无统计学意义(z=0.381,p=0.537>0.05)。说明紫杉醇联合洛铂在LACC患者术前新辅助化疗中与紫杉醇联合顺铂的效果相当,但是紫杉醇联合洛铂相对毒副反应发生率更低,提高了患者的治疗依从性,可以成为目前LACC治疗的首选方案,但未来还需进一步研究来提高其治疗效果。

The intention of the study was to inv estigate the effect of paclitaxel combined with platinum on neoadjuvant chemotherapy in patients with locally advanced cervical cancer（LACC）and its effect on serum tumor markers and long-term prognosis.A total of 58 cases of LACC patients treated by neoadjuvant chemotherapy in our hospital were selected,of which 29 cases were treated by neoadjuvant chemotherapy of paclitaxel combined with platinum（group A）,and other 29 patients were treated by paclitaxel combined with cisplatin in the treatment group（group B）.All patients underwent surgical treatment of radical cervical cancer.Their curative effect,the serum tumor markers,adverse reaction rate and long-term prognosis were compared.The research showed that the remission rate of group A was 82.75% and the total efficiency was 100%,but for the patients of group B,the remission rate was 68.97% and the total efficiency was 96.55%,the difference between the two groups were not statistically significant（p〉0.05）.After chemotherapy,serum CYFRA21-1 and SCCAg levels in group A and group B were significantly lower than those before chemotherapy（p〈0.05）.In the process of chemotherapy,the incidence of nausea and vomiting and diarrhea incidence in group A of patients were 17.24%,6.90%,respectively.the incidence of nausea and vomiting and diarrhea incidence in group B were 48.28%,62.07%,and two groups had significant difference（p〈0.05）.After 36 months of follow-up,the overall survival rate of group A in was 68.97%（20/29）,and the total survival rate in group B was 62.07%（18/29）,so the two groups had no statistically significant difference（χ~2=0.305,p=0.581〉0.05）.Analysis on the survival function curves of the two groups illustrated no significant difference in survival time（z=0.381,p=0.537〉0.05）.Therefore,the effect of paclitaxel combined with cisplatin in the preoperative neoadjuvant chemotherapy of LACC patients was equivalent to the combination therapy of paclitaxel and cisplatin,but the treatment of paclitaxel plus lobaplatin had relatively lower incidence of adverse reaction,and might improve the treatment compliance of patients,and could become the preferred solution for current LACC treatment,but its curative effect still need further study to be improved the in the future.