伊立替康联合奈达铂在局部晚期宫颈癌新辅助化疗中的疗效及肿瘤标志物分析

Analysis of the efficacy and tumor markers of irinotecan combined with nedaplatin in neoadjuvant chemotherapy for locally advanced cervical cancer

目的比较伊立替康联合奈达铂在局部晚期宫颈癌新辅助化疗(NACT)中的疗效和不良反应,并分析其肿瘤标志物水平。方法2020年3月至2023年3月,选取接受NACT的局部晚期宫颈癌患者,按照随机数表法分为对照组(紫杉醇联合顺铂)和观察组(伊立替康联合奈达铂),比较两组治疗疗效、肿瘤标志物、不良反应。结果共纳入患者74例,观察组与对照组各37例。与对照组比较,观察组的治疗总有效率(89.2%比67.6%)较高(P<0.05)。随访1年,观察组无进展生存期(PFS)为(10.5±1.1)个月,相较于对照组的(9.6±1.4)个月更长(P<0.05)。与治疗前比较,两组患者CA125、AFP、SCC-Ag、CEA治疗后均降低[观察组:(28.0±4.9)U/mL比(44.4±4.5)U/mL、(5.3±0.9)ng/mL比(6.9±1.3)ng/mL、(2.8±0.6)ng/mL比(7.0±1.3)ng/mL、(6.5±1.2)ng/mL比(13.1±2.3)ng/mL;对照组(36.3±5.6)U/mL比(43.4±7.3)U/mL、(5.9±1.1)ng/mL比(7.2±1.3)ng/mL、(3.4±0.6)ng/mL比(7.1±1.3)ng/mL、(7.7±1.2)ng/mL比(13.4±2.3)ng/mL,(P<0.05)];与对照组比较,观察组治疗后CA125、AFP、SCC-Ag、CEA低于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论与紫杉醇联合顺铂应用于局部晚期宫颈癌NACT比较,伊立替康联合奈达铂治疗效果较好,可更有效降低血清肿瘤标志物水平,且不会增加不良反应发生率。

Objective To evaluate the efficacy and adverse reactions of irinotecan combined with nedaplatin in neoadjuvant chemotherapy(NACT)for locally advanced cervical cancer,and to analyze tumor markers.Methods From March 2020 to March 2023,patients with locally advanced cervical cancer receiving NACT were selected and divided into a control group(paclitaxel combined with cisplatin)and an observation group(irinotecan combined with nedaplatin)using the method of random number table.The therapeutic efficacy,tumor markers,and adverse reactions were compared between the two groups.Results A total of 74 patients were included,with 37 cases in each group.Compared with the control group,the overall response rate of the observation group(89.2%vs 67.6%)was higher(P<0.05).With a 1-year follow-up,the progression free survival(PFS)of the observation group was(10.5±1.1)months,which was longer than that of the control group(9.6±1.4)months(P<0.05).Compared with before treatment,the levels of CA125,AFP,SCC-Ag,and CEA in both groups decreased after treatment[observation group:(28.0±4.9)U/mL vs(44.4±4.5)U/mL,(5.3±0.9)ng/mL vs(6.9±1.3)ng/mL,(2.8±0.6)ng/mL vs(7.0±1.3)ng/mL,(6.5±1.2)ng/mL vs(13.1±2.3)ng/mL;control group:(36.3±5.6)U/mL vs(43.4±7.3)U/mL,(5.9±1.1)ng/mL vs(7.2±1.3)ng/mL,(3.4±0.6)ng/mL vs(7.1±1.3)ng/mL,(7.7±1.2)ng/mL vs(13.4±2.3)ng/mL,(P<0.05)];Compared with the control group,the levels of CA125,AFP,SCC-Ag,and CEA after treatment in the observation group were lower than those in the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Compared with paclitaxel combined with cisplatin in NACT for locally advanced cervical cancer,irinotecan combined with nedaplatin has a better therapeutic effect,can more effectively reduce serum tumor markers,and does not increase adverse reactions.