顺铂在宫颈癌同步放化疗中3周方案与每周方案的应用效果与不良反应比较

Comparison of Application and Adverse Effects of Cisplatin in Three-week and Weekly Regimens of Concurrent Chemoradiotherapy for Cervical Cancer

目的比较顺铂于宫颈癌同步放化疗中采取三周方案和每周方案的临床效果及不良反应。方法对该医院治疗的70例宫颈癌患者予以临床分析,选择于2012年1月—2015年7月,按照信封法随机分组,一组入组35例,两组均采取盆腔外照射配合腔内照射放疗方法,每周方案组40 mg/m2顺铂,一周1次,连续6周。3周方案组80 mg/m2顺铂,第1、22天使用,统计两组临床有效率、急性毒性反应。结果每周方案组临床有效率(91.43%)比较于3周方案组(94.29%),差异无统计学意义(P>0.05);每周方案组急性毒性反应分度状况(胃肠道反应及骨髓抑制Ⅰ度、Ⅱ度、Ⅲ度、Ⅳ度分别为22例、10例、3例、0例及28例、5例、2例、0例)低于3周方案组(胃肠道反应及骨髓抑制Ⅰ度、Ⅱ度、Ⅲ度、Ⅳ度分别为20例、8例、7例、0例及18例、6例、6例、5例),差异有统计学意义(P<0.05)。结论在宫颈癌同步放化疗中采用顺铂每周方案的临床效果和顺铂三周方案基本相同,但顺铂每周方案的不良反应更少,存在治疗安全性。

Objective To compare the clinical effects and adverse reactions of cisplatin in the three-week and weekly regimens of concurrent chemoradiotherapy for cervical cancer.Methods A total of 70 patients with cervical cancer treated in our hospital were analyzed.From January 2012 to July 2015,they were randomly grouped according to the envelope method.A group of 35 patients were enrolled.Both groups were treated with pelvic external irradiation and intraluminal irradiation therapy,weekly regimen 40mg/m^2 cisplatin,once a week for 6 weeks.The 3-week regimen group was treated with 80 mg/m^2 cisplatin on days 1 and 22.The clinical effective rate and acute toxicity of the two groups were statistically analyzed.Results The clinical effective rate of the weekly regimen group(91.43%)was compared with the three-week regimen group(94.29%).There was no statistically significant difference(P>0.05).The acute toxicity index status of the weekly regimen group(gastrointestinal response and bone marrow suppression I degree,II degree,III degree,IV degree were 22 cases,10 cases,3 cases,0 cases and 28 cases,5 cases,2 cases,0 cases)lower than the three-week regimen group(gastrointestinal tract response and myelosuppression were I degree,II degree,III degree,and IV degree,respectively,20 cases,8 cases,7 cases,0 cases and 18 cases,6 cases,6 cases,5 cases).The data of different were statistically significant(P<0.05).Conclusion The clinical effect of the weekly cisplatin regimen in concurrent chemoradiotherapy for cervical cancer is basically the same as that of the cisplatin three-week regimen,but the cisplatin weekly regimen has fewer adverse reactions and is safe to treat.