摘要
目的：观察并对比奥沙利铂（L - OHP）、顺铂（DDP）分别联合多西紫杉醇（DTX）方案用于 Ib -Ⅱa 期宫颈癌患者新辅助化疗的近远期疗效与安全性，优化临床治疗方案。方法将2010-2011年收治的103例择期行根治术的 Ib -Ⅱa 期宫颈癌患者随机分为 A、B 两组，A 组53例患者术前予 DTX 联合 L - OHP 化疗方案，B 组予 DTX 联合 DDP方案，2周为1化疗周期，连续化疗3个周期，化疗结束后2-3周适情行广泛子宫切除术并盆腔淋巴结清扫，对比两组化疗后近期疗效、化疗期间毒性反应并2年复发率。结果新辅助化疗结束后，A 组 KPS 评分（82.6±5.7）明显高于 B组（80.4±5.3）（ t =2.025，P =0.046），A 组总有效率（67.9%）和临床获益率（94.3%）均高于 B 组（54.0%、86.0%），差异无统计学意义（ P 〉0.05）。化疗期间，A 组中性粒细胞减少（11.3% vs.28.0%）、血小板减少（5.7% vs.16.0%）、肾功损害（3.8% vs.14.0%）、脱发（32.1% vs.42.0%）等发生率大幅低于 B 组，两组中性粒细胞减少比率差异有统计学意义（χ2=4.574，P =0.032）。术中，A、B 两组宫旁组织及淋巴结癌阳性率（6.0% vs.11.6%）无显著性差异（fisher P=0.464）。术后2年 A、B 两组复发率（2.4% vs.5.3%）无显著差异（fisher P =0.498）。结论 Ib -Ⅱa 期宫颈癌患者术前采用 DTX 联合 L - OHP 化疗方案较 DTX 联合 DDP 方案在近期疗效方面具有比较优势，在降低骨髓抑制等毒性反应方面优势明显。
Objective To observe and compare short and long term efficacy and safety between oxaliplatin（L - OHP）/ docetaxel（DTX） regimen and cis - platin（DDP）/ DTX regimen for neoadjuvant chemotherapy of Ib - Ⅱa cervical carcinoma,and to optimize treatment plan. Methods One hundred and three Ib - Ⅱa cervical carcinoma patients who underwent radical resection during 2010 - 2011 were randomly divided into group A（n = 53）and group B（n = 50）. Patients in both received neoadjuvant chemotherapy,group A was treated with L - OHP/ DTX, group B was treated with DDP/ DTX regimen,2 weeks for 1 treatment cycle,and continuously for 3 cycles. 2 - 3 weeks after neoadjuvant chemo-therapy,extensive hysterectomy and pelvic lymph node dissection were implemented,and short term efficacy,toxicity reactions and 2 years recur-rence rate of 2 groups were compared. Results After neoadjuvant chemotherapy,KPS score in group A（82. 6 ＋ 5. 7）was higher than group B （80. 4 ＋ 5. 3）（ t = 2. 025,P = 0. 046）. The total effective rate of group A（67. 9% ）and clinical benefit rate（94. 3% ）in group A were higher than group B（54. 0% and 86. 0% ,respectively）,but no significant differences（ P 〉 0. 05）. During chemotherapy,incidence of neutropenia, thrombocytopenia,renal damage,and hair loss in group A and group B were11. 3% vs. 28. 0% ,5. 7% vs. 16. 0% ,3. 8% vs. 14. 0% ,and 32. 1% vs. 42. 0% ,respectively. There was statistically significant difference in neutropenia ratio（χ2 = 4. 574,P = 0. 032）. During operation,no significant difference in parametrial tissue and lymph node cancer positive rate was found between group A and group B（6% vs. 11. 6% ）（fisher P = 0. 464）. Two years after surgery,the recurrence rate in group A and group B（2. 4% vs. 5. 3% ）had no significant difference（Fisher P =0. 498）. Conclusion Compared with DDP/ DTX regimen,L - OHP/ DTX neoadjuvant chemotherapy has comparative advantages in short term ef-ficacy for Ib - Ⅱa cervical carcinoma,and has obvious advantages in reduction of bone marrow inhibition.
出处
《临床和实验医学杂志》
2015年第9期764-767,共4页
Journal of Clinical and Experimental Medicine
关键词
宫颈癌
新辅助化疗
奥沙利铂
顺铂
多西紫杉醇
Cervical cancer
Neoadjuvant chemotherapy
Oxaliplatin
Cisplatin
Docetaxel
