DTX对比TAX辅助化疗对术前局部晚期宫颈癌的临床应用效果

Clinical Efficacy of DTX and TAX Adjuvant Chemotherapy for Patients with Locally Advanced Cervical Cancer

目的对比多西他赛(Docetaxel,DTX)联合顺铂(DDP)与紫杉醇(Paclitaxel,TAX)联合DDP新辅助化疗治疗局部晚期宫颈癌的临床疗效及不良反应。方法选取228例ⅠB2期~ⅡB期宫颈癌患者,以随机组表对照法分为2组,分别为TP(n=114,TAX 135 mg/m^2+DDP 75 mg/m^2)组和DP(n=114,DTX 75 mg/m^2+DDP 75 mg/m^2)组,在宫颈癌手术之前,进行2次新辅助化疗,对化疗结果及副反应比较分析。结果 (1)新辅助化疗有效率2组间差异无统计学意义(P>0.05)。(2)DP组WBC减少、神经毒性反应发生率低于TP组,2组差异有统计学意义(P<0.05);Hb减少、肝脏损伤发生率2组间无统计学差异(P>0.05),未出现不可控制副反应。(3)2组手术后的标本病理反应率与淋巴结阳性率等比较,差异无统计学意义(P>0.05)。结论 2种辅助化疗在中晚期宫颈癌新辅助化疗中的临床效果相近,但多西他赛不良反应较紫杉醇轻,值得临床关注。

Objective To compare the clinical efficacy and side effects of docetaxel combined with cisplatin and paclitaxel combined with cisplatin adjuvant chemotherapy in the treatment of locally advanced cervical cancer. Methods 228 cases of stage ⅠB2 ~stage ⅡB cervical cancer patients were divided into 2 groups,TP（ n =114,TAX 135 mg/m 2＋DDP 75 mg/m 2） group and DP （ n =114,DTX 75 mg/m 2＋DDP 75 mg/m 2） group,before surgery conduct 2 neoadjuvant chemotherapy.A comparative analysis of the results and side effects of chemotherapy were conducted. Results There was no significant difference in the effective rates of neoadjuvant chemotherapy between the 2 groups （ P 〉0.05）.The occurrence of WBC decrease,neurotoxicity of DP group was lower than that of TP group,there was significant difference between 2 groups （ P 〈0.05）;Hb decrease and liver injury had no significant difference between the 2 groups （ P 〉0.05）,without any uncontrollable side effects.The pathological reaction rate of the 2 groups after operation and the positive rate of lymph node had no statistically significant difference（ P 〉 0.05 ）. Conclusion The clinical efficacy of 2 kinds of adjuvant chemotherapy in neoadjuvant chemotherapy for advanced cervical cancer is similar,but the adverse reactions of docetaxel is less than paclitaxel,which is worthy of clinical attention.