盆腔外照射、高剂量率后装联合5-FU、DDP治疗IIB—IVA期宫颈癌疗效比较

【目的】比较盆腔外照射、高剂量率后装联合5-氟尿嘧啶(5-fluorouracil,5-FU)、顺铂(Cisplatin,DDP)月疗或DDP周疗治疗IIB—IVA期宫颈癌的近期疗效及不良反应,探讨治疗晚期无远处转移宫颈癌的优化方案。【方法】80例符合纳入标准的宫颈癌患者被随机分为A、B组,每组40例。两组患者均行DT 30 Gy全盆腔野照射,随后中央挡铅板照射,DT 20 Gy。腔内照射A点总剂量42 Gy。A组给予5-FU 1 000 mg/m2/day,DDP 20 mg/m2/day,静滴5 d,28 d为1疗程,共3疗程。B组每周给予DDP 30 mg/m2静滴,共6疗程。观察两组肿瘤消退、并发症及治疗依从性。【结果】B组完成化疗及放疗人数均显著大于A组(P<0.05)。完成放化疗剂量≥80%的人数显著大于A组(P<0.05)。A组III度以上骨髓抑制及III级以上恶心呕吐反应率显著大于B组(P<0.05)。治疗后3个月两组患者完全缓解率无统计学差异(P>0.05)。【结论】两组方案治疗晚期无远处转移宫颈癌的疗效相似,但DDP周疗毒性反应低,依从性好,可行性强。

Evaluation of clinical efficacy of pelvic radiotherapy and high-dose rate brachytherapy concurrent with monthly fluorouracil and cisplatin versus concurrent with weekly cisplatin for stage IIB-IVA advanced cervical cancer

【Objective】 Treadmill testing To compare treatment outcomes,compliance with treatment and acute toxicity of the monthly fluorouracil plus cisplatin concurrent with pelvic radiotherapy and high-dose rate brachytherapy with that of weekly cisplatin concurrent with radiotherapy for locally advanced cervical cancer.【Methods】 A total of 80 Eligible patients with stage IIB to IVA uterine cervical cancer were randomly divided to two groups： Group A received 3 cycles of 5-fluorouracil（1000 mg/m2/day iv） plus cisplatin（20 mg/m2/day iv）for 5 days at 28 day intervals（n=40）.Group B received 6 cycles of weekly ciplatin（30 mg/m2 iv）.All patients were treated with radiotherapy consisted of external irradiation to the whole pelvis of 50 Gy in 25 fractions plus high-dose rate（HDR） intracavitary brachytherapy 42 Gy in 7 fractions to point A.Compliance with treatment,toxicity,response was analyzed and compared.【Results】 The rate of completion of chemotherapyand the rate of completion of radiotherapy in group B were higher than these in group A（P0.05）.The rate of received ≥80 % full dose of planned chemotherapy and radiotherapy in group B was higher than that in group A（P0.05）.The number of patients with severe,grade III hematologic toxicity in group A was more than that in group B（P0.05）.3 months after treatment,the remission rate was no significant difference between in group A and group B（P0.05）.【Conclusion】 The regimen of chemoradiation using weekly cisplatin significantly improves compliance with treatment and reduces acute hematologic toxicity,while not affecting response.