紫杉醇联合卡铂与氟尿嘧啶联合卡铂治疗艾滋病并发晚期阴茎癌的临床对比分析

目的比较紫杉醇联合卡铂与5-氟尿嘧啶（5-Fu）联合卡铂治疗艾滋病并发晚期阴茎癌患者临床疗效、不良反应及预后。方法选择经病理或细胞学以及血清学证实的58例艾滋病并发晚期阴茎癌患者，其中30例接受紫杉醇联合卡铂方案化疗（TC组），28例接受5-Fu联合卡铂方案化疗（FC组），按实体瘤的疗效评价标准(RECIST)1.0版评价近期疗效，按美国癌症研究所常见毒性判定标准（NCI-CTC）3.0版评价不良反应。结果58例均可评估疗效，TC组和FC组的客观总有效率分别为56.7%和17.9%（χ²=9.265，P=0.002），中位疾病进展时间分别为11.15月和7.22月（χ²=6.737，P=0.009）,中位生存时间分别为17.36月和9.11月（χ²=10.646，P=0.001）。两组主要不良反应均为骨髓抑制及恶心呕吐，Ⅲ～Ⅳ度白细胞减少发生率分别为46.4%和40.0%（χ²=0.222，P=0.637），Ⅲ～Ⅳ度恶心呕吐的发生率分别为36.0%和34.78%（χ²=0.008，P=0.930）。结论紫杉醇联合卡铂化疗方案治疗艾滋病并发晚期阴茎癌是安全和有效的。

Clinical Analysis of Combination Chemotherapy with Paclitaxel Plus Carboplatin and 5-Fu Plus Carboplatin for Advanced Penile Carcinoma in HIV-positive Patients

Objective To compare the clinical efficacy and toxicity of paclitaxel versus 5-fluorouracil(5-Fu) combined with carboplatin for the treatment in patients with advanced penile carcinoma associated with AIDS.Methods Fifty-eight patients were enrolled in this study,these patients with advanced penile carcinoma and infected by HIV which were confirmed by serologic biopsy and cytology evidence.Thirty patients in the paclitaxel and carboplatin group(TC group) administered paclitaxel at a dose of 175 mg/m2 given intravenously on day one,carboplatin at a dose of AUC=5 given intravenously on day one every 21 days cycle.Twenty-eight patients in 5-Fu and carboplatin group(FC group) administered 5-Fu at a dose of 1 000 mg/m2 given intravenously on four consecutive days,carboplatin at a dose of AUC=5 given intravenously on day one every 21 days cycle.Results All the 58 patients were assessable for response.The objective overall response rate was 56.7% in paclitaxel and carboplatin group and 17.9% in 5-Fu and carboplatin group,respectively(χ2=9.265,P=0.002).The median time to disease progression was 11.15 months vs.7.22 months(χ2=6.737,P=0.009).The median duration of response was 17.36 months vs.9.11 months(χ2=10.646,P=0.001).The most common toxicity was myelosuppression,nausea,vomit.The rates of grade Ⅲ~Ⅳ leucopenia were 46.4% and 40.0%(χ2=0.222,P=0.637).The rates of grade Ⅲ~Ⅴ nausea and vomit were 36.0% and 34.78%(χ2=0.008,P=0.930).Conclusions Combination chemotherapy with paclitaxel and carboplatin is an effective and safe regimen in the treatment for patients with advanced penile carcinoma associated with AIDS.