中国实用医药
中國實用醫藥
중국실용의약
CHINA PRACTICAL MEDICAL
2015年
1期
11-12,13
,共3页
宫颈癌%同步放化疗%紫杉醇%顺铂
宮頸癌%同步放化療%紫杉醇%順鉑
궁경암%동보방화료%자삼순%순박
Cervical cancer%Concurrent chemoradiotherapy%Paclitaxel%Cisplatin
目的：探索含高危因素宫颈癌根治性术后紫杉醇联合顺铂同步放化疗的疗效及毒性。方法180例宫颈癌患者均行根治性手术,术后病理证实具有高危因素,并于术后3~4周行辅助同步放化疗。治疗方案：研究组(TP组)为紫杉醇135~150 mg/m2 d1+顺铂25~30 mg/m2 d1~3,每3周1次同步化疗。对照组(P组)为顺铂35~40 mg/m2,每周1次同步化疗。全组病例采用相同放疗方案：总放疗剂量45~59 Gy,1.8~2.2 Gy/次,4~5次/周。主要研究内容为5年无局部复发生存率(LRFS)、5年无瘤生存率(DFS)、5年无远处转移生存率(FDMS)、5年总生存率(OS)以及毒性反应。结果全组中位随访期33个月(1~84个月),未能观察到研究组较对照组可以提高无瘤生存期、无局部复发生存期和总生存期。研究组和对照组5年无远处转移生存率分别为95.4%和82.6%,差异具有统计学意义(P=0.034<0.05)。而研究组治疗期间37.8%的患者出现了3/4级白细胞下降,44.4%的患者出现严重骨髓抑制。结论与顺铂相比,紫杉醇联合顺铂辅助同步放化疗未能提高含高危因素的宫颈癌术后患者的总生存率,但它具有提高无远处转移生存率的优势,而且除了血液学毒性外,其毒副作用整体可接受。
目的：探索含高危因素宮頸癌根治性術後紫杉醇聯閤順鉑同步放化療的療效及毒性。方法180例宮頸癌患者均行根治性手術,術後病理證實具有高危因素,併于術後3~4週行輔助同步放化療。治療方案：研究組(TP組)為紫杉醇135~150 mg/m2 d1+順鉑25~30 mg/m2 d1~3,每3週1次同步化療。對照組(P組)為順鉑35~40 mg/m2,每週1次同步化療。全組病例採用相同放療方案：總放療劑量45~59 Gy,1.8~2.2 Gy/次,4~5次/週。主要研究內容為5年無跼部複髮生存率(LRFS)、5年無瘤生存率(DFS)、5年無遠處轉移生存率(FDMS)、5年總生存率(OS)以及毒性反應。結果全組中位隨訪期33箇月(1~84箇月),未能觀察到研究組較對照組可以提高無瘤生存期、無跼部複髮生存期和總生存期。研究組和對照組5年無遠處轉移生存率分彆為95.4%和82.6%,差異具有統計學意義(P=0.034<0.05)。而研究組治療期間37.8%的患者齣現瞭3/4級白細胞下降,44.4%的患者齣現嚴重骨髓抑製。結論與順鉑相比,紫杉醇聯閤順鉑輔助同步放化療未能提高含高危因素的宮頸癌術後患者的總生存率,但它具有提高無遠處轉移生存率的優勢,而且除瞭血液學毒性外,其毒副作用整體可接受。
목적：탐색함고위인소궁경암근치성술후자삼순연합순박동보방화료적료효급독성。방법180례궁경암환자균행근치성수술,술후병리증실구유고위인소,병우술후3~4주행보조동보방화료。치료방안：연구조(TP조)위자삼순135~150 mg/m2 d1+순박25~30 mg/m2 d1~3,매3주1차동보화료。대조조(P조)위순박35~40 mg/m2,매주1차동보화료。전조병례채용상동방료방안：총방료제량45~59 Gy,1.8~2.2 Gy/차,4~5차/주。주요연구내용위5년무국부복발생존솔(LRFS)、5년무류생존솔(DFS)、5년무원처전이생존솔(FDMS)、5년총생존솔(OS)이급독성반응。결과전조중위수방기33개월(1~84개월),미능관찰도연구조교대조조가이제고무류생존기、무국부복발생존기화총생존기。연구조화대조조5년무원처전이생존솔분별위95.4%화82.6%,차이구유통계학의의(P=0.034<0.05)。이연구조치료기간37.8%적환자출현료3/4급백세포하강,44.4%적환자출현엄중골수억제。결론여순박상비,자삼순연합순박보조동보방화료미능제고함고위인소적궁경암술후환자적총생존솔,단타구유제고무원처전이생존솔적우세,이차제료혈액학독성외,기독부작용정체가접수。
Objective To explore the curative effect and toxicity of postoperative concurrent chemoradiotherapy with paclitaxel and cisplatin for cervical cancer with high risk factors.Methods There were 180 patients with cervical cancer who underwent radical operation and had high risk factors confirmed by postoperative pathology. Concurrent chemoradiotherapy was conducted in 3~4 weeks after operation. Research group (TP group) took 135~150 mg/m2 d1 of paclitaxel+25~30 mg/m2 d1~3 of cisplatin once in 3 weeks for concurrent chemoradiotherapy. Control group (P group) took 35~40 mg/m2 of cisplatin once in 1 week. The radiotherapy method for both groups was the same as 45~59 Gy of total radiotherapy dose, and 1.8~2.2 Gy/time and 4~5 times/week. The main study contents were 5-year local recurrence free survival (LRFS), 5-year disease free survival (DFS), 5-year distance metastasis free survival (DMFS), 5-year overall survival (OS) and toxic reaction. Results The time of median follow-up was 33 months (1~84 months), and no significant differences were found in DFS, LRFS, or OS between the two groups. The 5-year DMFS in research group and control group were 95.4% and 82.6% respectively (P=0.034<0.05). However, there were 37.8% of patients had grade 3/4 leukopenia and 44.4% of patients had severe myelosuppression in research group during treatment.Conclusion Compared with cisplatin, concurrent chemoradiotherapy with paclitaxel and cisplatin can not improve the OS of cervical cancer patients with high risk factors, but it has the advantage of promoting DMFS. Its toxic and side effects are tolerant, except for hematological toxicity.
