【摘要】 目的评价周剂量多西他赛和奈达铂同步放化疗治疗中晚期宫颈癌的疗效和毒性反应。方法 58例中晚期宫颈癌患者随机分成两组:观察组(多西他赛和奈达铂同步放化疗)30例,多西他赛35 mg/m2,第1、8天,奈达铂40 mg/m2,第1、8天。对照组(单纯放疗)28例。放疗均采用直线加速器(6MV,X线)调强适形放疗(IMRT)。两组均于放疗剂量达4 000 cGy(4周)时根据妇科检查及CT检查结果判断,可手术者行根治性手术,仍无手术指征者继行IMRT加252C f后装治疗至根治量。观察组同时行第2周期化疗。结果观察组手术切除率为36.67%,高于对照组的21.43%,但无统计学意义(P>0.05);观察组近期有效率为96.67%,明显高于对照组的78.57%,有统计学意义(P<0.05);3年生存率观察组为86.66%,明显高于对照组的64.28%,有统计学意义(P<0.05)。观察组急性白细胞下降发生率高于对照组(P<0.05),但可以耐受,其他毒性反应无统计学意义(P>0.05)。结论周剂量多西他赛和奈达铂同步放化疗治疗中晚期宫颈癌,能提高近期疗效及3年生存率;急性毒性反应略增加,但可以耐受。更多还原

【Abstract】 Objective To evaluate the clinical curative effect and toxicity of weekly docetaxel and nadaplatin concurrent chemoradiotherapy for local advanced cervical cancer.Methods Fifty-eight patients with local advanced cervical cancer were randomly divided into the study group(n=30)and the control group(n=28).The patients in study group received IMRT concurrent with chemotherapy of weekly docetaxel and nadaplatin(docetaxel 35 mg/m2 d1,8,nadaplatin 40 mg/m2 d1,8).The patients in control group were treated only with radiotherapy.All patients received IMRT using 6MV-X ray.After 40 Gy therapy,the patients evaluated with down stage according to gynecological examination and CT examination were for operation,and the others continued to IMRT and additional brachytherapy with 252californium until radical dose.The study group received the second cycle of chemotherapy at the same time.Results The resection rate was 36.67% in the study group and 21.43% in the control group(P>0.05).The response rate was highter in the study group(96.67%)than that of in the control group(78.57%)(P<0.05).The three-year survival rate of the patients were 86.66% in the study group and 64.28% in the control group respectively(P<0.05).The incidence of acute bone marrow inhibition was higher in the study group than that in the control group(P<0.05),but it could be tolerated.There was no significant difference between two groups about other toxicities(P>0.05).Conclusion Weekly docetaxel and nadaplatin concurrent chemoradiotherapy in local advanced cervical cancer can obviously improve the short-term effect and 3-year survival rate of the patients.The acute toxicity of patients was slightly increasing but could to be tolerated.更多还原