紫杉醇＋顺铂同步放、化治疗局部中晚期宫颈癌的临床观察

目的观察紫杉醇＋顺铂同步放、化治疗局部中晚期宫颈癌的疗效和毒副反应。方法将70例Ⅱb-Ⅳa期宫颈癌患者随机分为两组，即单纯放疗组36例，同步放、化疗组34例，体外照射常规分割每周5次，2Gy／f，总剂量：50Gy／25f／5W，铱-192腔内近距离治疗1次／周；A点剂量：36-42Gy／6-7f。化疗方案采用紫杉醇135mg／m^2，第1天静滴；顺铂30mg，第1—4天静滴，28d为1周期，共用两周期。结果同步放、化疗组治疗有效率明显高于单纯放疗组（P〈0．05），患者骨髓抑制、恶心、呕吐、腹泻等消化道毒副反应明显高于单纯放疗组（P〈0．05）。晚期放射性直肠炎、放射性膀胱炎发生率，两组比较差异无统计学意义（P〉0．05）。结论紫杉醇＋顺铂化疗同步配合放疗能提高局部晚期宫颈癌患者的近期疗效，毒副反应患者能耐受。

Clinical efficacy of concurrent chemoradiotherapy using paclitaxel and cisplatin in the treatment of advanced cervical cancer

Objective To investigate the clinical efficacy of concurrent chemoradiotherapy using paclitaxel and cisplatin in the treatment of advanced cervical cancer. Methods 70 patients with local advanced cervical cancer at stages Ⅱb-Ⅳa were randomly divided into 2 groups with 36 patients received radiotherapy alone and the others received concurrent chemoradiotherapy. The same radiotherapy was performed to all patients. External beam radiation was delivered with a fraction dose of 2 Gy per day for 5 days a week during a 5-week period and fraction size of intracavitary brachytherapy is 6-7 Cy to point A. Pacilitaxel at 135 mg/m^2 was administered in the first day and cisplatin at 30 mg was administered from the first to the fourth day. The total was 2 cycles with 28 days per cycle. Results The efficacy of concurrent chemoradiotherapy was significantly higher than that of radiotherapy alone （P 〈0.05） and the side effects in concurrent chemoradiotherapy group were significantly higher than those in radiotherapy alone （P 〈0.05）, including bone marrow suppression, nausea, vomiting, diarrhea and other gastrointestinal reactions. There were no significant differences in radiated rectisis rate and radiated cystisis rate between concurrent chemoradiotherapy and radiotherapy alone （P 〈0.05）. Conclusion Concurrent chemoradiotherapy using paclitaxel and cisplatin might improve short-term efficacy of local advanced cervical cancer within tolerable toxicity.