多西他赛联合顺铂同步放化疗治疗中晚期宫颈癌的疗效及安全性观察

Clinical efficacy and safety of docetaxel combined with cisplatin concurrent chemoradiotherapy in treatment of middle and advanced cervical cancer

目的探讨多西他赛联合顺铂同步放化疗治疗中晚期宫颈癌的临床疗效安全性。方法收集2010年6月至2016年6月收治的67例中晚期宫颈癌患者,其中同步放化疗组36例(多西他赛联合顺铂同步放化),单纯放疗组31例。放化疗组化疗应用TP方案,3周为1个周期,连续治疗2~3个周期。具体用药为多西他赛75 mg/m^2,静脉滴注,第1天;顺铂75 mg/m2,静脉滴注,第1~3天。化疗当天开始行放射治疗,放疗方案与单纯放疗组相同。治疗结束4周后比较2组患者的临床效果、不良反应,并随访2组患者复发率及2年内生存率。结果67例均按治疗计划完成了治疗,同步放化疗组有效率63.89%,显著高于单纯放疗组有效率38.71%(χ^2=4.233,P=0.040);同步放化疗组患者的胃肠道反应、骨髓抑制发生情况明显高于对照组(P<0.05);随访期间,同步放化疗组转移率为13.89%,明显低于对照组,差异有统计学意义(P<0.05);同步放化疗组2年生存率为86.11%,生存时间(21.51±0.61)个月,均明显高于对照组,差异有统计学意义(P<0.05)。结论多西他赛联合顺铂化疗同步放疗可提高中晚期宫颈癌患者疾病治疗效果和生存率,减少了复发转移的发生,值得临床重视。

Objective To investigate the clinical efficacy and safety of docetaxel combined with cisplatin concurrent chemoradiotherapy in treatment of the middle and advanced cervical cancer.Methods A total of 67 patients with middle and advanced cervical cancer who were admitted and treated in our hospital from June 2010 to June 2016 were enrolled in the study,including 36 patients in concurrent chemoradiotherapy group(docetaxel combined with cisplatin concurrent radiochemotherapy)and 31 patients in simple radiotherapy group.The TP plan was used in chemoradiotherapy group,with a treatment course of 3 weeks for 2~3 courses continuous treatment.The medication was docetaxel 75mg/m2,intravenous drip,the first day;cisplatin 75mg/m^2,intravenous drip,d1~d3.Radiation therapy was started at the same day of chemotherapy,and the radiotherapy plan was the same as that in simple radiotherapy group.After 4-week treatment,the clinical effects and adverse reactions were observed and compared between the two groups,moreover the recurrence rate and survival rate within 2 years were follow-up in both groups.Results All the 67 patients were completed the treatment according to the treatment plan.The effective rate in concurrent radiochemotherapy group was significantly higher than that in simple radiotherapy group(63.89%vs 38.71%,P<0.05).Moreover the incidence rates of gastrointestinal reaction,myelosuppression in concurrent chemoradiotherapy group were significantly higher than those in control group(P<0.05).During follow-up,the metastatic rate in radiochemotherapy group(13.89%)was significantly lower than that in control group(P<0.05).The 2-year survival rate(86.11%)and the total survival time[(21.51±0.61)months]in concurrent radiochemotherapy group were significantly higher than those in control group(P<0.05).Conclusion The docetaxel combined with cisplatin concurrent chemoradiotherapy can improve the therapeutic effects and survival rate of patients with middle and advanced cervical cancer,and reduce the occurrence of recurrence and metastasis of tumor which is worthy of clinical attention.