CAJ | 학술논문

目的比较分析Ⅰ b2～Ⅳa期宫颈鳞癌患者同步放化疗中两种含铂化疗方案的疗效和安全性.方法回顾性分析2007年11月至2011年11月北京大学肿瘤医院收治的接受同步放化疗的宫颈鳞癌患者共146例的临床病理资料,根据同步放化疗中化疗方案的不同分为两组:铂类单药每周方案化疗(单药化疗组)59例,氟尿嘧啶+铂类联合3周方案化疗(联合方案组)87例.治疗结束3个月后进行评效,比较两组患者的近期疗效、生存率和毒性反应发生情况.结果单药化疗组和联合方案组患者的有效率分别为97％(57/59)、93％(81/87),两组比较,差异无统计学意义(P=0.249).单药化疗组、联合方案组患者的5年总生存率分别为61.2％和69.5％,5年无进展生存率分别为43.3％和24.4％,5年局部复发率分别为11.8％和9.8％,5年远处转移率分别为29.4％和38.7％,分别比较,差异均无统计学意义(P＞0.05).毒性反应发生情况:联合方案组的消化道毒性反应(恶心、呕吐)发生率明显高于单药化疗组[分别为78％(68/87)、51％ (30/59),P＜0.01],且其贫血较单药化疗组更常见[贫血发生率分别为53％ (46/87)、25％ (15/59),P=0.019]；但急性和晚期放射性直肠炎、膀胱炎及其他常见毒性反应的发生率比较,差异无统计学意义(P＞0.05).结论两种同步放化疗方案的疗效相当,铂类单药每周方案的毒性反应发生率明显低于含铂的3周联合方案.
목적 비교분석Ⅰ b2～Ⅳa기궁경린암환자동보방화료중량충함박화료방안적료효화안전성.방법 회고성분석2007년11월지2011년11월북경대학종류의원수치적접수동보방화료적궁경린암환자공146례적림상병리자료,근거동보방화료중화료방안적불동분위량조:박류단약매주방안화료(단약화료조)59례,불뇨밀정+박류연합3주방안화료(연합방안조)87례.치료결속3개월후진행평효,비교량조환자적근기료효、생존솔화독성반응발생정황.결과 단약화료조화연합방안조환자적유효솔분별위97％(57/59)、93％(81/87),량조비교,차이무통계학의의(P=0.249).단약화료조、연합방안조환자적5년총생존솔분별위61.2％화69.5％,5년무진전생존솔분별위43.3％화24.4％,5년국부복발솔분별위11.8％화9.8％,5년원처전이솔분별위29.4％화38.7％,분별비교,차이균무통계학의의(P＞0.05).독성반응발생정황:연합방안조적소화도독성반응(악심、구토)발생솔명현고우단약화료조[분별위78％(68/87)、51％ (30/59),P＜0.01],차기빈혈교단약화료조경상견[빈혈발생솔분별위53％ (46/87)、25％ (15/59),P=0.019]；단급성화만기방사성직장염、방광염급기타상견독성반응적발생솔비교,차이무통계학의의(P＞0.05).결론 량충동보방화료방안적료효상당,박류단약매주방안적독성반응발생솔명현저우함박적3주연합방안.
Objective To compare the clinical efficacy and safety of two chemotherapy regimens for concurrent chemoradiotherapy in patients with stage Ⅰ b2 to Ⅳ a squamous cell carcinoma of the uterine cervix.Methods Between November 2007 and November 2011,146 patients with stage Ⅰ b2 to Ⅳ a squamous cell carcinoma of the uterine cervix who received concurrent chemoradiotherapy in Peking University Cancer Hospital were analyzed.All cases were divided into two groups according to the different chemotherapy regimens during radiation therapy,the group receiving radiotherapy concomitant with weekly cisplatin or nedaplatin alone (platinum alone group,n =59),the group receiving radiotherapy concomitant with cisplatin plus fluorouracil or nedaplatin plus tegafur every 3 weeks (combined group,n =87).There were no statistical difference in the clinical and pathological characteristics between the two groups.Results Patients were evaluated by pelvic examination and pelvic MRI after chemoradiotherapy for 3 months according to WHO criteria.The response rate were respectively 97％ (57/59) and 93％ (81/87) in platinum alone group and combined group,in which there was no significant difference (P =0.249).The five-year overall survival and the five-year progression-free survival of platinum alone group and combined group were respectively 61.2％ versus 69.5％ (P ＞ 0.05) and 43.3％ versus 24.4％ (P ＞ 0.05).There were also no statistically significant differences between platinum alone group and combined group in the five-year local recurrence rate and five-year distant metastasis (11.8％ versus 9.8％,29.4％ versus 38.7％ ; all P ＞ 0.05).Acute gastrointestinal toxicities (nausea and vomiting) in combined group were exactly higher than that in the other group [78％ (68/87) versus 51％ (30/59),P ＜0.01].Moreover,anaemia was slightly more common in combined group [53％ (46/87) versus 25％ (15/59),P =0.019].However,the occurrence rate of the acute or late proctitis and cystitis did not reveal difference between two groups (P ＞ 0.05).Conclusions Both concurrent chemoradiotherapy regimens had similar efficacy on cervical cancer patients with stage Ⅰ b2 to Ⅳa.But the toxicity was lower in patients with weekly platinum than those with platinum-based combined regimens during radiation therapy.