奈达铂、顺铂在局部晚期宫颈癌同步放化疗疗效及不良反应分析

Analysis of efficacy and adverse reactions of nedaplatin and cisplatin in concurrent chemoradiotherapy of locally advanced cervical cancer

目的探究奈达铂、顺铂在局部晚期宫颈癌患者同步放化疗治疗中的应用效果以及安全性。方法 98例局部晚期宫颈癌患者,均接受同步放化疗治疗。根据化疗药物不同分成奈达铂组(48例)和顺铂组(50例)。同期化疗:顺铂组患者于放疗第1天给予患者顺铂静脉滴注。奈达铂组于放疗第1天给予患者奈达铂静脉滴注。对比两组治疗效果及不良反应发生率。结果顺铂组治疗有效率为82.0%,奈达铂组治疗有效率为83.3%,两组患者治疗有效率比较差异无统计学意义(P>0.05)。两组放射性直肠炎发生率和肝肾功能异常发生率比较差异无统计学意义(P>0.05);顺铂组胃肠道不适发生率(32.0%)明显高于奈达铂组(8.3%)(P<0.05);顺铂组白细胞减少、血小板减少和骨髓抑制发生率均低于奈达铂组(P<0.05)。结论局部晚期宫颈癌的同步放化疗治疗中顺铂和奈达铂均具有较好的疗效,安全性无明显区别,但奈达铂的胃肠道反应较少,有助于提高患者对同步放化疗的耐受性和依从性。

Objective To investigate the effect and safety of nedaplatin and cisplatin in concurrent chemoradiotherapy of locally advanced cervical cancer.Methods A total of 98 patients with locally advanced cervical cancer all receiving concurrent chemoradiotherapy were divided by different chemotherapeutics into nedaplatin group（48 cases） and cisplatin group（50 cases）.Concurrent chemoradiotherapy：cisplatin group received intravenous infusion of cisplatin at 1 st day,and nedaplatin group received intravenous infusion of nedaplatin at 1 st day.Comparison were made on treatment effect and incidence of adverse reactions between the two groups.Results Cisplatin group had treatment effective rate as 82.0%,which was 83.3% in nedaplatin group,and both groups had no statistically significant difference in treatment effective rate（P〈0.05）.Both groups had no statistically significant difference in incidence of radiation proctitis and liver and kidney dysfunction（P〈0.05）.Cisplatin group had obviously higher incidence of gastrointestinal discomfort（32.0%） than nedaplatin group（8.3%）（P〈0.05）.Cisplatin group had lower incidence of leukopenia,thrombocytopenia and myelosuppression than nedaplatin group（P〈0.05）.Conclusion Cisplatin and nedaplatin are both effective and safe in the concurrent chemoradiotherapy for locally advanced cervical cancer,but nedaplatin has fewer gastrointestinal reactions,which helps to improve the tolerance and compliance of patients with concurrent chemoradiotherapy.