奈达铂对照顺铂同步放疗治疗中晚期宫颈癌的近期疗效及安全性评价

目的 比较奈达铂或顺铂同步根治性放疗治疗局部晚期宫颈癌的疗效和安全性。方法 回顾性分析2012年1月至2014年1月63例ⅠB2～ⅣA期宫颈癌患者的临床资料，其中奈达铂同步放疗组29例，顺铂同步放疗组34例。体外照射采用三维适形放疗，总剂量50 Gy／25 f；腔内照射A点后装总剂量30 Gy。顺铂40 mg／m2静滴，放疗开始后每周1次，共6次。奈达铂40 mg／m2静滴，放疗开始后每周1次，共6次。结果 奈达铂组获CR 19例、PR 9例、PD 1例，有效率（RR）为96.5％；顺铂组获CR 28例、PR 6例，RR为100.0％，两组RR的差异无统计学意义（P＞0.05）。奈达铂组2年无复发生存率和2年无转移生存率分别为93.1％和86.2％，顺铂组分别为91.2％和88.2％，差异均无统计学意义（P＞0.05）。两组主要不良反应为白细胞减少、血小板减少、恶心呕吐和放射性肠炎。奈达铂组3～4级恶心呕吐的发生率为17.2％，顺铂组为41.1％，差异有统计学意义（P＜0.05）；其他不良反应发生率的差异均无统计学意义（P＞0.05）。结论 奈达铂同步放疗治疗中晚期宫颈癌的疗效与顺铂相似，胃肠道反应较顺铂轻，安全性良好。

Efficacy and safety of concurrent chemoradiation with nedaplatin or cisplatin for locally advanced cervical cancer

Objective To compare the efficacy and safety of nedaplatin or cisplatin combined with concurrent radiotherapy in patients with locally advanced cervical cancer.Methods A total of 63 diagnosed stage Ⅰ B2 ～ ⅣA cervical cancer patients were retrospectively reviewed,among whom 29 patients received nedaplatin with concurrent radiation(nedaplatin 40mg/m2 iv once a week for 6 weeks) and 34 patients received cisplatin with concurrent radiation(cisplatin 40mg/m2 iv once a week for 6 weeks).The radiotherapy included pelvis three-dimensional conformal radiotherapy plus brachytherapy,and the total dose of A point was 30 Gy,and while the total dose of three-dimensional conformal radiotherapy was 50/25 f.Results In nedapiatin group,there were 19 cases in CR,9 cases in PR,1 case in PD,and the response rate(RR) was 96.5％.In cisplatin group,there were 28 cases in CR and 6 cases in PR,and the RR was 100.0％.The difference of RR between the two groups had no statistical significance(P＞0.05).The 2-year recurrence-free survival rate and 2-year metastasis-free survival rate in nedaplatin group was 93.1％ and 86.2％,while in cisplatin group they were 91.2％ and 88.2％ (P＞0.05).The main side effects of the two groups were leukopenia,thrombocytopenia,nausea/vomiting and radiation enteritis.The incidence of grade 3-4 nausea/vomiting in nedapiatin group (17.2％) was lower than that in cisplatin group (41.1％) with statistical significance(P＜0.05).No significant differences were found in other side effects.Conclusion Nedaplatin showed similar efficacy as cisplatin in combination with concurrent radiotherapy,and the incidence of digestive tract reaction was lower than cisplatin with good safety.