两种同步化疗方案联合放疗对中晚期宫颈癌疗效及不良反应比较

目的：比较两种同步化疗方案联合放疗治疗中晚期宫颈癌的疗效及不良反应。方法回顾性分析138例中晚期宫颈癌患者的临床资料，按不同治疗方式分为A、B两组，其中A组为同步顺铂（DDP）化疗+放疗组（75例），B组为同步DDP+5-氟尿嘧啶（5-Fu）化疗+放疗组（63例），分析比较两组患者的近期疗效、不良反应及5年生存率。结果 A、B两组近期有效率分别为89.3%和92.1%，两组比较差异无统计学意义（P﹥0.05）。A、B两组5年生存率分别为62.7%和68.3%，两组比较差异无统计学意义（P﹥0.05）。两组的放射性直肠炎和放射性膀胱炎的发生率差异无统计学意义（P﹥0.05），而白细胞降低等3级及以上骨髓抑制不良反应A组较B组严重，恶心、呕吐等3级及以上胃肠道不良反应B组较A组严重，差异均有统计学意义（P﹤0.05）。结论 DDP与DDP+5-Fu化疗方案联合放疗治疗中晚期宫颈癌的近期疗效及远期疗效相近，但DDP化疗+放疗骨髓抑制严重，DDP+5-Fu化疗+放疗胃肠道不良反应严重。

The efficacy and adverse reactions of two concurrent chemotherapy regimens combined with radiotherapy for locally advanced cervical cancer

Objective To compare the efficacy and adverse reactions of two concurrent chemotherapy regimens com-bined with radiotherapy in the treatment of locally advanced cervical cancer. Method 138 patients with locally advanced cervical cancer who received concurrent chemoradiotherapy were included in the analysis, and were stratified as group A or B as per respective chemotherapy regimens, with group A receiving cisplatin (DDP)+radiotherapy (n=75), and group B the concurrent DDP+5-Fu+radiotherapy (n=63), and the short-term efficacy, adverse reactions and 5-year survival rate of the two groups were compared. Result The short-term response rate was 89.3%and 92.1%(P>0.05), while the 5-year overall survival was 62.7%and 68.3%in group A and B, respectively (P>0.05). The incidence rate of radiation proctitis and cystitis was similar between the two groups (P>0.05), however the marrow suppression (leukocytopenia) of grade III or above was more severe in group A than in group B, though more patients with gastrointestinal toxicities of grade III or above (including nausea and vomiting) were observed in group B compared with group A, and the difference was statisti-cally significant (P<0.05). Conclusions Both concurrent chemoradiotherapy regimens are similar in regard of short-term and long-term efficacy for advanced cervical cancer, but DDP+radiotherapy is of higher risk of bone marrow suppression, while DDP+5-Fu+radiotherapy may induce severer gastrointestinal adverse reactions.