雷替曲塞联合奈达铂对复发性子宫颈癌的疗效及不良反应初探

Preliminary Study on the Efficacy and Adverse Reaction of Raltitrexed Combined with Nedaplatin in the Treatment of Recurrent Cervical Cancer

目的:探讨复发性子宫颈癌采用雷替曲塞与奈达铂联合治疗的临床效果及不良反应。方法:选择2016年6月至2018年12月在中国医科大学附属盛京医院妇产科收治的复发性子宫颈癌患者39例进行回顾性分析,按照化疗方案不同分为观察组(采用雷替曲塞联合奈达铂方案化疗)9例和对照组(采用紫杉醇联合顺铂或卡铂方案化疗)30例,比较两组临床疗效及不良反应情况。结果:①观察组和对照组客观有效率(ORR)分别为77.8%(7/9)和76.7%(23/30),疾病控制率(DCR)分别为88.9%(8/9)和86.7%(26/30),无进展生存期(PFS)中位数分别为12.3±2.2个月和11.3±1.4个月,生活质量改善率分别为88.9%和83.3%,两组比较差异无统计学意义(P>0.05)。②在不良反应分级中,观察组白细胞发生Ⅲ~Ⅳ级下降率(0)明显低于对照组(6.7%),观察组均出现轻度白细胞下降,而对照组40.0%出现下降,两组白细胞下降率的分布比较,差异有统计学意义(P<0.05)。两组其他不良反应发生率的分布比较,差异无统计学意义(P>0.05)。结论:雷替曲塞联合奈达铂治疗复发性子宫颈癌安全、有效,其疗效与紫杉醇联合顺铂或卡铂化疗疗效相近,但白细胞下降增多,其他不良反应无差异。

Objective:To investigate the clinical effect and adverse reaction of raltitrexed combined with nedaplatin in the treatment of recurrent cervical cancer.Methods:Totally 39 patients with recurrent cervical cancer at the Department of Obstetrics and Gynecology in Shengjing Hospital of China Medical University,from June 2016 to December 2018 were analyzed retrospectively.According to the different chemotherapy regimens,the patients were divided into observation group(altitrexed combined with nedaplatin,9 cases)and control group(paclitaxel plus cisplatin or carboplatin,30 cases).The clinical curative effect and adverse reactions in these two groups were compared.Results:① Objective response rate(ORR)in the observation group and the control group were77.8%(7/9)and 76.7%(23/30),the disease control rates(DCR)were 88.9%(8/9)and 86.7%(26/30),the median PFS was 12. 3 ± 2. 2 months and 11. 3 ± 1. 4 months,and the life quality improvement rates were88. 9% and 83. 3% respectively.The differences between the two groups was no statistically significant difference( P> 0. 05).(2)In terms of adverse reactions,Ⅲ-Ⅳ magnitude drop rate of white blood cells in the observation group( 0) was significantly lower than that in the control group( 6. 7%).In the observation group,mild white blood cells was declined in all patients,while in the control group only 40% patients had declined,there was significant difference in the decline rate between the two there was no significant difference between the two groups in the other adverse reactions( P> 0. 05).Conclusions: Raltitrexed combined with nedaplatin is safe and effective in the treatment of recurrent cervical cancer.It’s curative and adverse reactions are similar to that of paclitaxel combined with cisplatin or carboplatin,excet leukocyte mild decrease.