宫颈癌术后奈达铂同步调强放疗的临床研究

目的 在早期宫颈癌术后放疗中联合奈达铂（NDP）每周同步化疗,以顺铂（DDP）每周同步化疗作为对照组,分析两组患者近期不良反应的差异.方法 24例Ⅰb期至Ⅱa期宫颈鳞癌根治术后有不良预后因素的患者,随机分成奈达铂组12例,顺铂组12例.两组化疗方案为：NDP 30 mg/m2静脉滴注,每周1次;DDP 30 mg/m2静脉滴注,每周1次.放疗均采用调强放疗,盆腔区域照射剂量45～50 Gy/25次.结果 全组24例患者均顺利完成调强放疗.NDP组12例患者中有1例（8.3%）因出现3级中性粒细胞减少而终止化疗;DDP组12例患者中有5例（41.7%）因出现2级及以上急性不良反应而终止化疗,两组化疗完成情况差异有统计学意义（P〈0.05）.NDP组胃肠道反应发生率为25%,显著低于DDP组75%（P〈0.05）;而血液毒性反应,放射性直肠炎、放射性膀胱炎,以及肝脏和肾脏毒性指标差异无统计学意义（P〉0.05）.结论 NDP方案同步放化疗辅助治疗宫颈癌,与传统的顺铂方案比较更容易实施,而且有较少的胃肠道反应发生.

Clinical study of nedaplatin-based concurrent chemoradiation with intensity-modulated radiotherapy for postoperative cervical cancer

Objective To compare the toxicity of concurrent nedaplatin（NDP） or cisplatin（DDP） based chemoradiation for postoperative cervical carcinoma with high - risk factors. Methods From November 2009 to September 2012, 24 eases of postoperative cervical cancer patients with high - risk factors from stage I B to l] A were randomly divided into NDP group and DDP group. All patients received intensity-modulated radiotherapy （IMRT） of pelvic cavity, and the total dose was 45 -50 Gy/25f. Patients in NDP/DDP group received nedaplatin/cisplatin 30 mg/m2 weekly. Results All the patients accomplished their adjunctive IMRT. There was 1 case （8.3%） and 5 cases （41.7 % ） in NDP and DDP group respectively which had not accomplished concurrent chemotherapy for toxicity, with a significant difference between two groups （ P 〈 0. 05 ）. The incidence of anorexia, nausea, vomiting and loss of body weight in NDP group were less than those in DDP group with significant difference （ P 〈 0.05 ）. The incidence of thrombocytopenia, leucopenia, acute cystitis and reetitis had no significant differences between the two groups. Conclusion The toxicity of the two groups has no significant difference but gastrointestinal tract reaction is different. NDP group has a lower rate of nausea, vomiting and loss of body weight, and a better tolerance than DDP group.