目的：观察雷替曲塞、顺铂联合同期放疗对中晚期宫颈癌的临床疗效和安全性；方法选择65例ⅡB~ⅣA期宫颈癌患者，采用含雷替曲塞加顺铂化疗方案联合同步放射治疗，3周为1周期，雷替曲塞3 mg·m-2，静滴15 min，d1；顺铂60mg·m-2，静滴60 min，d1；盆腔放疗采用三维适形方法。治疗2周期后评价临床疗效和不良反应发生情况。结果65例患者全部完成2周期治疗，其中7例患者因白细胞下降，化疗延期1周完成。治疗总有效率为95.4％，3年无病生存率为75.4％，3年总生存率为90.7％。≥3级急性不良反应主要为白细胞减少（23.1％）和血小板下降（6.2％）。≥3级晚期不良反应发生率为1.5％，1例患者于放疗后8个月开始反复出现不全性肠梗阻，最终行手术治疗。结论雷替曲塞联合顺铂方案同步放疗治疗中晚期宫颈癌的疾病控制率高，毒副反应可耐受。%Objective To explore the effectiveness and safety of reltitrexed/cisplatin with concurrent radiotherapy in treating patients with advanced cervical cancer. Methods Sixty-five patients with stage IIB-IVA cervical cancer were enrolled in this study and received reltitrexed/cisplatin with concurrent radiotherapy. The treatment consisted of reltitrexed 3 mg·m-2 iv 15 min, d1, cisplatin 60 mg·m-2 iv 60 min, d1, every 21 days. Pelvic radiotherapy adopted the three-dimensional conformal radiotherapy. The effectiveness and toxicity were investigated after two cycles of chemotherapy. Results A total of 65 patients completed radio-therapy with two cycles of chemotherapy. Seven patients had their chemotherapy delayed for a week due to hypoleucocytosis. The total response rate, three-year disease-free survival (DFS), and three-year overall survival (OS) were 95.4%, 75.4%and 90.7%, respectively. High-grade (≥3) acute toxicities were hypoleucocytosis (23.1%) and thrombocytopenia (6.2%) with an incidence of high-grade (≥3) late toxicities at 1.5%. One patient finally received surgical resection because of a partial intestinal obstruction after eight months of radiotherapy. Conclusion Reltitrexed/cisplatin combined with concurrent radiotherapy is effective in treat-ing advanced cervical cancer and its toxicities could be tolerant.
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