三维适形放疗联合力扑素周化疗治疗宫颈癌腹主动脉旁淋巴结转移的临床研究

目的探讨三维适形放射治疗联合力扑素（LPS）周化疗对宫颈癌腹主动脉旁淋巴结转移的短期疗效和不良反应。方法 64例宫颈癌腹主动脉旁淋巴结转移患者分为单纯放疗组和联合治疗组,每组各32例,两组患者均给予适形放疗,20 Gy/f,每周5次,腹主动脉旁总剂量60 Gy。联合治疗组在三维适形放疗的同时,行力扑素周化疗,每周60 mg/m2,连续3周为1个周期,2个周期后间隔1周。观察临床效果和不良反应。结果单纯放疗组的总有效率为56.3%,临床控制率为81.3%;联合治疗组的总有效率为81.3%,临床控制率为93.8%。两组总有效率差异有统计学意义（P〈0.05）。联合治疗组患者白细胞减少的发生率高于单纯放疗组（P〈0.05）,血小板减少、过敏反应和感觉异常等不良反应发生率差异无统计学意义（P〉0.05）。结论三维适形放疗联合力扑素周化疗能够显著增强宫颈癌腹主动脉旁淋巴结转移的近期疗效,除白细胞减少,其他不良反应未见明显增加。

Clinical study of 3-dimensional conformal radiotherapy combined with paclitaxel Liposome in the treatment of paraaortic lymph node metastasis of cervical cancer

Objective To investigate short-term effect and safety of paclitaxel liposome(LPS) with 3-dimensional conformal radiotherapy(3D-CRT)on paraaortic lymph node metastasis of cervical cancer.Methods 64 cases of paraaortic lymph node metastasis of cervical cancer were divided two groups: were the combination group(32 cases) treated with 3-dimensional conformal radiotherapy combined with LPS and the radiation group(32 cases) were tneated by radio theapy alone.The dose was 200 Gy per fraction,five times a week,the paraaortic total dose ranged 60 Gy.LPS was given at 60 mg/m2 per week(three weeks a cycle,one week interval between two cycles),simultaneously with 3D-CRT.The clinical effect and adverse responses were observed.Results The total response rate(RR) were 56.3% and 81.3%(P<0.05),and the disease control rate(DCR) 81.3% and 93.8% in radiation group and combination group(P>0.05),respectively.The occurrence of neutropenia was significantly lower in radiation group than in combination group(P<0.05),and occurrence of thrombocytopenia,anaphylaxis and cacesthesia had no difference between groups(P>0.05).Conclusion Paclitaxel liposome combined with 3-dimensional conformal radiotherapy can significantly improve short-term effect on paraaortic lymph node metastasis of cervical cancer without increasing occurrence of adverse responses except neutropenia which is still in the acceptable extent.