紫杉醇联合顺铂方案同步放化疗治疗中晚期宫颈癌近期疗效观察
Short-term efficacy of paclitxel plus cisplatin combined with adiotherapy on advanced cervix cancer
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摘要: 目的:观察紫杉醇联合顺铂方案同步放化疗治疗中晚期宫颈癌的近期疗效和不良反应。方法:选择Ⅱb~Ⅲb期宫颈癌36例同步放化疗,放疗分次量每次2 Gy,每周5次,总剂量50 Gy,体外照射开始后1周,采用192Ir高剂量率子宫腔内后装照射,腔内照射每周1次,A点剂量每次7Gy,共6次。放疗期间采用紫杉醇135 mg/m2,d1,顺铂25 mg/m2,d1~d3方案同步化疗,每3~4周重复,共2周期,观察近期疗效和不良反应。结果:36例患者完全缓解27例,部分缓解7例,进展2例,有效率94.4%。患者病理类型和临床分期间有效率差异均无统计学意义(P0.05)。不良反应主要为中性粒细胞下降和放射性直肠反应。结论:紫杉醇联合顺铂同步放化疗近期疗效肯定,不良反应可以耐受。Abstract: Objective: To observe the short-term efficacy and toxicity of paclitxel plus cisplatin combined with radiotherapy in treatment of advanced cervix cancer.Methods: Thirty-six patients with advanced cervix cancer (Ⅱ b-Ⅲ b ) received concurrent chemoradiotherapy.The external irradiation dose of radiotherapy was 2Gy per time,5d /W,with a total dose of 50Gy; 192 Ir high-dose-rate afterloading unit was adopted for branchytherapy one week after external radiotherapy, at a dose of 7 Gy per time in A point for 6 times.Paclitxel (135mg /m2 ,d1 ) and cisplatin (25mg /m2 ,d1- d3 ) were given every 3- 4 weeks for two cycles concurrently with radiotherapy.The short effectiveness and toxic reaction were observed in these patients.Results: Of the 36 cases, complete response was observed in 27 cases,partial response in 7 cases and two cases presented certain progress.The overall response rate was 94.4%.There was no statistical significance in differences of patients' pathologic patterns and clinical stages(P0.05) .The main toxicities were leucopenia and radiation rectal reaction.Conclusions: The short term efficacy of concurrent chemoradiotherapy with paclitxel and cisplatin is relatively good on patients with advanced cervical cancer, and the side effects are well tolerated.