TP与TC方案治疗中晚期宫颈癌的疗效比较

目的：比较紫杉醇＋顺铂（TP）与紫杉醇＋卡铂（TC）治疗中晚期宫颈癌的疗效和不良反应。方法：回顾性分析2007年1月-2010年9月我院收治的Ⅱb~Ⅳa期93例宫颈癌患者资料，所有患者均为初次根治性放疗。根据化疗方案的不同分为两组，A组：紫杉醇＋顺铂联合3周化疗方案44例；B组：紫杉醇＋卡铂联合3周化疗方案49例。 A、B组均采用根治性放疗（体外放疗＋腔内后装治疗），每周放疗5次。治疗结束后比较两组疗效及不良反应发生的情况。结果：A组近期有效率为91%，B组近期有效率为94%，两组比较差异无统计学意义（P=0.704）。 A、B组3年总生存率分别为65.9%和61.2%，3年无进展生存率分别为52.3%和49.0%，3年局部复发率分别为13.6%和12.2%，3年远处转移率分别为34.1%和38.8%，分别比较差异均无统计学意义（P〉0.05）。不良反应：消化道反应、肾功能损害、周围神经毒性和肌肉关节痛A组明显较B组重（P〈0.05）。结论：TP与TC方案治疗中晚期宫颈癌的疗效相当，但TC方案不良反应明显减轻，更易被患者接受，特别适用于老年患者及对顺铂耐受性差的患者。

Comparison between paclitaxel plus cisplatin and paclitaxel plus carboplatin in the treatment of advanced cervical cancer

Objective：To compare the efficacy and toxicity of paclitaxel plus cisplatin and paclitaxel plus carboplatin in the treatment of advanced cervical cancer. Methods：Between January 2007 and September 2010,93 cervical cancer patients with stageⅡb toⅣa who received Initial radical radiotherapy in our hospital. All cases were divided into two groups according to different chemotherapy regimens,the group receiving paclitaxel plus cisplatin chemotherapy every three weeks （group A,n=44）,the group receiving paclitaxel plus carboplatin chemotherapy every three weeks（group B,n=49）,Group A and Group B all adopt radical radiotherapy （external radiotherapy plus intracavitary brachytherapy）,five times a week. Situation of efficacy and toxicity occurred were compared after the end of treatment. Results： The response rate（CR＋PR） in group A was 91% and in group B was 94%,in which there was no significant difference（P=0.704）. The three-year overall survival and the three-year progression-free survival of group A and group B were respectively 65.9%vs 61.2%（P〉0.05） and 52.3%vs 49.0%（P〉0.05）. There were also no statistically significant differences between group A and group B in the three-year local recurrence rate and three-year distant metastasis（13.6% vs 12.2%,34.1% vs 38.8%;all P〉0.05）. Gastrointestinal reaction,renal dysfunction, myalgia or arthralgia and Peripheral neurotoxicity in group A was exactly higher than those in group B（P〈0.05）. Conclusions：Both chemotherapy regimens had similar efficacy on advanced cervical cancer patients with stage Ⅱb toⅣa. But the toxicity was milder in patients with paclitaxel plus carboplatin than those with paclitaxel plus cisplatin ,paclitaxel plus carboplatin is easy to be accepted by patients, and is especially suitable for the elderly and the patients with low tolerance to cisplatin.