CAJ | 학술논문

目的：探讨紫杉醇联合铂类方案治疗中晚期宫颈癌患者临床疗效及对CYFRA21-1、SCC-Ag的影响。方法中晚期宫颈癌患者104例随机分为观察组和对照组各52例，观察组应用紫杉醇联合铂类方案治疗，对照组应用伊立替康联合铂类方案治疗。观察2组的临床疗效、不良反应及生存质量，并对比血清肿瘤标记物CYFRA21-1、SCC-Ag变化情况。结果观察组有效率67 J.3％（35／52）高于对照组44.2％（23／52）（χ2=10.815， P ＜0.05）。治疗后2组CYFRA21-1、SCC-Ag均较治疗前降低[（2.12±1.03）vs.（4.56±2.07）、（1.67±1.04）vs.（3.85±1.17）]（ P均＜0.05），且观察组低于对照组（ t =7.409、9.439， P ＜0.05）。治疗后，2组躯体功能、情绪功能、社会功能、疲乏、食欲减退、疼痛方面均改善（观察组t =3.759、3.964、3.738、3.316、3.670、3.057，对照组t =3.251、2.341、2.465、1.906、2.590、2.317， P均＜0.05），且除躯体功能方面外、以上其余方面观察组均优于对照组（ t =1.661、1.928、1.764、1.838、1.554， P均＜0.05），消化道反应、骨髓抑制、肌肉关节疼痛、白细胞下降、血小板下降发生率观察组明显低于对照组（χ2=3.898、2.797、6.522、4.300、2.659， P均＜0.05），呼吸困难、脱发、肝肾功能损伤发生率方面，2组比较差异无统计学意义（χ2=0.210、0.070、0.153， P ＞0.05）。结论紫杉醇联合铂类方案治疗中晚期宫颈癌疗效确切、有效率高、不良反应少、能延长患者生存时间、提高患者的生存质量，值得临床推广应用。
목적：탐토자삼순연합박류방안치료중만기궁경암환자림상료효급대CYFRA21-1、SCC-Ag적영향。방법중만기궁경암환자104례수궤분위관찰조화대조조각52례，관찰조응용자삼순연합박류방안치료，대조조응용이립체강연합박류방안치료。관찰2조적림상료효、불량반응급생존질량，병대비혈청종류표기물CYFRA21-1、SCC-Ag변화정황。결과관찰조유효솔67 J.3％（35／52）고우대조조44.2％（23／52）（χ2=10.815， P ＜0.05）。치료후2조CYFRA21-1、SCC-Ag균교치료전강저[（2.12±1.03）vs.（4.56±2.07）、（1.67±1.04）vs.（3.85±1.17）]（ P균＜0.05），차관찰조저우대조조（ t =7.409、9.439， P ＜0.05）。치료후，2조구체공능、정서공능、사회공능、피핍、식욕감퇴、동통방면균개선（관찰조t =3.759、3.964、3.738、3.316、3.670、3.057，대조조t =3.251、2.341、2.465、1.906、2.590、2.317， P균＜0.05），차제구체공능방면외、이상기여방면관찰조균우우대조조（ t =1.661、1.928、1.764、1.838、1.554， P균＜0.05），소화도반응、골수억제、기육관절동통、백세포하강、혈소판하강발생솔관찰조명현저우대조조（χ2=3.898、2.797、6.522、4.300、2.659， P균＜0.05），호흡곤난、탈발、간신공능손상발생솔방면，2조비교차이무통계학의의（χ2=0.210、0.070、0.153， P ＞0.05）。결론자삼순연합박류방안치료중만기궁경암료효학절、유효솔고、불량반응소、능연장환자생존시간、제고환자적생존질량，치득림상추엄응용。
Objective To explore the effect of paclitaxel plus platinum regimen in the treatment of advanced cervical cancer patients and effect on CYFRA 21-1, and SCC-Ag.Methods Advanced cervical cancer of 104 cases were randomly di-vided into observation group and control group with 52 cases in each group , the observation group used paclitaxel plus platinum regimen for the treatment , control group used irinotecan plus platinum regimen .Therapeutic effect , the adverse reaction and quality of life, and the serum tumor markers CYFRA21-1, SCC-Ag changes of 2 groups were observed and compared .Results The observation group's effective rate was 67.3%(35/52), which was higher than 44.2% in the control group (23/52) (χ2 =10.815, P <0.05).The 2 groups after treatment's CYFRA21-1, SCC-Ag were lower than those before therapy (2.12 ± 1.03) vs.(4.56 ±2.07) and (1.67 ±1.04) vs.(3.85 ±1.17) ( P <0.05),and the observation group was better than in the control group( t =7.409、9.439, P <0.05).After treatment, 2 groups's physical function, emotional function, social function, fatigue, loss of appetite, pain was improved (observation group:t =3.759,3.964,3.738,3.316,3.670,3.057;control group:t =3.251,2.341,2.465,1.906,2.590,2.317, P <0.05),and except somatic function, the rest of observa-tion group was better than the control group ( t =1.661,1.928,1.764,1.838,1.554, P <0.05),gastrointestinal reactions, bone marrow suppression , muscles and joints the pain , the decrease of white blood cells , platelets decreased in the observation group was significantly lower than that of the control group (χ2 =3.898,2.797,6.522,4.300,2.659, P <0.05), difficulty in breathing , hair loss , liver and kidney function damage incidence revealed no statistical significance difference between the 2 groups (χ2 =0.210,0.070,0.153, P >0.05).Conclusion Paclitaxel combined with platinum chemotherapy in the treat-ment of advanced cervix carcinoma showed exact and high effective rate , fewer adverse reactions , it can prolong the survival time of patients , improve the quality of life of patients , it is worthy of clinical application .