伊立替康联合奈达铂治疗中晚期宫颈癌48例临床分析

Effect of irinotecan combined with nedaplatin on advanced cervical cancer in 48 cases

目的比较伊立替康联合奈达铂与多西他赛联合奈达铂治疗中晚期宫颈癌的临床效果。方法中晚期宫颈癌患者102例,采用伊立替康+奈达铂化疗者48例为观察组,采用多西他赛+奈达铂化疗治疗者54例为对照组;观察2组临床疗效、主要化疗不良反应情况,分析治疗前、后血清鳞状上皮细胞癌抗原水平变化,以及患者5a生存率和生存质量。结果观察组恶心和/或呕吐发生率(22.92%)低于对照组(59.26%)(P<0.05),腹泻发生率(20.83%)高于对照组(1.85%)(P<0.01);观察组白细胞计数降低、中性粒细胞绝对值降低发生率(10.42%、8.33%)低于对照组(51.85%、55.56%)(P<0.05),完全缓解率(41.67%)高于对照组(20.37%)(P<0.05);治疗后2组血清鳞状上皮细胞癌抗原水平均低于治疗前(P<0.05),组间比较差异无统计学意义(P>0.05);观察组45例、对照组54例进行定期随访,观察组5a无瘤生存率(87.5%)高于对照组(77.78%),复发率(4.17%)低于对照组(18.52%)(P<0.05)。结论伊立替康联合奈达铂治疗中晚期宫颈癌可提高患者生存率和生存质量,且不良反应发生率较低。

Objective To compare the clinical effects of irinotecan combined with nedaplatin and docetaxel combined with nedaplatin on advanced cervical cancer. Methods In 102 patients with advanced cervical cancer, 48 patients were treated with intravenous injection of irinotecan combined with nedaplatin （observation group）, and 54 patients were treated with intravenous injection of docetaxel combined with nedaplatin （control group）. The clinical effects and major adverse reactions were observed in two groups. The changes of squamous cell carcinoma antigen were detected before and after treatment. The 5-year survival rate and the life quality were followed up. Results The incidence of nausea and/or vomiting was significantly lower in observation group （22.92%） than that in control group （59.26%） （P〈0.05）, and the incidence of diarrhea （20. 83%） was significantly higher than that in control group （1. 85%） （P〈0.01）. The incidences of decreased white blood count and nentrophil absobute value were significantly lower in observation group （10.42%, 8. 33%） than those in control group （51. 85%, 55. 56%） （P〈0.05）. The complete remission rate was significantly higher in observation group （41.67%） than that in control group （20.37%） （P〈0.05）. The squamous cell carcinoma antigen levels were significantly lower after treatment than those before treatment in both two groups （P〈 0.05）, and there was no significant difference between two groups （P〉0.05）. Totally 45 patients in observation group and 54 patients in control group were regularly followed up, which showed that the 5-year disease-free survival rate was significantly higher and the recurrence rate was significantly lower in observation group （87.5%, 4.17%） than that in control group （77. 78%, 18. 52%） （P〈 0.05）. Conclusion Irinotecan combined with neidaplatin can improve the survival rate and life quality as well as reduce the incidence of adverse reactions in patients with advanced cervical cancer.