紫杉醇联合奈达铂或卡铂治疗上皮性卵巢癌的临床疗效比较

目的探讨紫杉醇联合奈达铂或卡铂在上皮性卵巢癌化疗中的疗效，为临床上有效安全的化疗方案的选择提供参考依据。方法选取于2011年3月-2013年8月上海交通大学附属第六人民医院收治的卵巢癌患者102例，随机分为治疗组（n=51）和对照组（n=51），治疗组第1天给予紫杉醇注射液175mg／m2，加入500mL生理盐水中静脉滴注，3h内滴完，第2天给予注射用奈达铂100mg／m2进行静脉滴注。对照组第1天紫杉醇用法用量同治疗组，第2天给予注射用卡铂400mg／m2进行静脉滴注。28d为一个疗程，所有患者化疗146个疗程，平均3个疗程。治疗结束后，比较两组的疗效和毒副作用。结果治疗组和对照组治疗有效率分别为64．71％、60．78％，两组比较差异无统计学意义。治疗过程中两组患者均可发生血红蛋白减少、中性粒细胞减少、白细胞减少、血小板减少、皮疹、脱发、恶心呕吐、肝功能和神经感觉异常的毒副作用，其中两组患者发生脱发的发生率均为100％，血红蛋白减少、中性粒细胞减少、白细胞减少、恶心呕吐的发生率均在50％以上。治疗组患者没有发生发热、过敏的毒副作用，神经感觉异常的发生率也低于对照组，两组比较差异有统计学意义（P〈0．05）。结论紫杉醇联合奈达铂或卡铂治疗上皮性卵巢癌的临床疗效无差异，主要毒副作用为骨髓抑制和胃肠道反应。临床医生可根据患者自身耐受情况、经济条件进行合理选择化疗方案，有利于减少患者化疗痛苦，提高患者依从性。

Comparison of clinical efficacy between taxinol combined with nedaplatin or carboplatin in treatment of epithelial ovarian cancer

Objective To explore the efficacy of taxinol combined with nedaplatin or carboplatin in treatment of epithelial ovarian cancer, and to provide the reference for effective and safe selection of chemotherapy regimens. Methods Epithelial ovarian cancer patients （102 cases） who came to the Sixth Affiliated Hospital of Shanghai Jiao Tong University from March 2011 to August 2013 were randomly divided into treatment and control groups （n = 51）. The patients in the treatment group were given Taxinol Injection on day l, 175 mg/m2 added in 500 mL saline, kept iv drip slowly in 3 h. They were injected with nedaplatin （100 mg/m2） for iv drip on day 2. The patients in the control group were treated with taxinol on day i, and the usage and dosage were the same as treatment group. They were injected with carboplatin （400 mg/m2） for iv drip on day 2. One course was 28 d, and all patients accepted 1-6 courses of chemotherapy with an average of three courses. Efficacy and side effects of two groups were compared. Results The effective rates in the treatment and control groups were 64.71% and 60.78%, without significant differences. Patients in both groups had side effects such as reduced hemoglobin, neutropenia, and leukopenia, skin rash, hair loss, nausea, vomiting, abnormal liver function and nerve sensation. The incidence of hair loss in two groups was 100%, and the incidence of reduced hemoglobin, neutropenia, and leukopenia, nausea, and vomiting was above 50%. Patients in the treatment group did not have fever and allergies, and the incidence of abnormal nerve sensation was lower than that of the control group with significant difference （P 〈 0.05）. Conclusion There is no difference between paclitaxel combined with nedaplatin or carboplatin in treatment of epithelial ovarian cancer, and the main side effects were bone marrow suppression and gastrointestinal reaction.Clinicians can select the reasonable chemotherapy regimens according to the own clinical tolerance and economic conditions of patients, which helps to reduce the pain of patients and improve their chemotherapy compliance.