紫杉醇在治疗晚期或复发性宫颈癌中的应用分析

Analysis of Paclitaxel in the Treatment of Advanced or Recurrent Cervical Cancer

为了探讨紫杉醇在治疗晚期或复发性宫颈癌中的疗效和安全性,为不适合手术或者放射治疗的患者(包括晚期或复发性宫颈癌患者)注射紫杉醇170 mg/m^2、卡铂5 mg·mL^-1·min^-1、贝伐珠单抗12 mg/kg治疗,每20 d一次,并记录期间的不良反应,直至疾病有所缓解或其毒性有所限制。总共有38名患者接受了平均8个治疗周期(范围2~25),中期随访值为18.5个月(范围2~29)。结果显示,19名患者(50.0%)经历完全反应,而15名患者经历(39.4%)部分反应,平均持续时间为6个月。3级和4级血液学毒性表现为中性粒细胞减少症15例(39.4%)、白细胞减少症13例(34.2%)、贫血症13例(34.2%)、血小板减少症11例(28.9%)。1名接受过骨盆照射的患者发生了2级直肠阴道瘘。本研究表明,紫杉醇、卡铂和贝伐单抗的组合对于晚期或复发性宫颈癌患者是有效且安全的。

To investigate the efficacy and safety of paclitaxel in the treatment of advanced or recurrent cervical cancer.For those who are not suitable for surgery or radiation therapy(including patients with advanced or recurrent cervical cancer),the injection included paclitaxel 170 mg/m^2,carboplatin 5 mg·mL^-1·min^-1,and bevacizumab12 mg/kg.Once every 20 days until the development of the disease is completely relieved or the toxicity is limited,the adverse reactions during the recording.A total of 38 patients received an average of 8 treatment cycles(range from 2 to 25).The median follow-up value was 18.5 months(range from 2 to 29).The results showed that 19 patients(50.0%) experienced a complete response,while 15 patients experienced(39.4%) partial response with an average duration of 6 months.Grade 3 and 4 hematologic toxicity showed neutropenia in 15 cases(39.4%),leukopenia in13 cases(34.2%),anemia in 13 cases(34.2%),thrombocytopenia in 11 cases(28.9%).A grade 2 rectal vaginal fistula occurred in a patient who had undergone pelvic irradiation.This study demonstrates that the combination of paclitaxel,carboplatin and bevacizumab is effective and safe for patients with advanced or recurrent cervical cancer.