奈达铂联合化疗在晚期妇科恶性肿瘤中的临床疗效对比研究

摘要

目的:通过奈达铂/紫杉烷与奥沙利铂/紫杉烷、卡铂/紫杉烷联合化疗方案对比,了解奈达铂/紫杉烷在晚期妇科恶性肿瘤化疗中的近期疗效和毒副反应.方法:2009年1月至2011年6月郑州大学第二附属医院妇产科收治晚期妇科恶性肿瘤患者137例,分为3组化疗方案治疗组,回顾性对比分析各组化疗方案的近期疗效和毒副反应.结果:奈达铂组、奥沙利铂组、卡铂组的总有效率分别为81.82%、80.43%、76.60%,奈达铂组有效率与奥沙利铂组和卡铂组的比较差异均无统计学意义(P>0.05).奈达铂组血红蛋白降低发生率低于奥沙利铂组,差异无统计学意义(P>0.05),白细胞降低、中性粒细胞降低及肝功能损伤的发生率低于奥沙利铂组,差异有统计学意义(P<0.05).奈达铂组胃肠道反应发生率低于奥沙利铂组,差异无统计学意义(P>0.05).奈达铂组血小板降低的发生率高于卡铂组(42.03% vs.37.42%),差异无统计学意义(P>0.05).奈达铂组Ⅲ～Ⅳ度骨髓抑制发生率49.2%,与卡铂组相比差异无统计学意义(P>0.05).奈达铂组未见过敏反应、肾功能损伤,少部分神经感觉异常.结论:奈达铂为新一代有效的广谱抗肿瘤药物,其联合化疗的近期疗效与奥沙利铂、卡铂比较差异无统计学意义,毒副反应以骨髓抑制和胃肠道反应为主,与奥沙利铂、卡铂的比较无明显差异,临床可根据患者的具体情况进行选择.%Objective: To determine the near-term therapeutic efficacy and toxicity of a nedaplatin/taxane regimen in patients with advanced gynecological neoplasms by comparing this regimen with oxaliplatin/taxane and carboplatin/taxane combination chemotherapy. Methods: From January 2009 to June 2011, chemotherapy regimens containing nedaplatin/taxane ( Group 1 ), oxaliplatin/taxane ( Group 2 ), or carboplatin/ taxane ( Group 3 ) was given to 137 patients with advanced gynecological neoplasms. A retrospective comparative study of the curative effect and toxicity of the chemotherapies was conducted in the three treatment groups. Results: The effective response rates were 81.82%, 80.43%, and 76.60% in Groups 1, 2, and 3, respectively. However, there was no statistically significant difference among the three groups. Both gastrointestinal toxicity and hepatic toxicity were lower in Group 1 than in Group 2, but the difference was not statistically significant ( P > 0.05 ). The incidence of neutropenia was significantly lower in Group 1 than in Group 2 (P = 0.01 ). The incidence of thrombopenia was higher in Group 1 than in Group 3 ( 42.03% and 37.42%, respectively ), but the difference was not statistically significant ( P > 0.05 ). Symptoms of anaphylaxis and nephrotoxicity were not observed in Group 1, although mild neurotoxicity was observed in a few patients. Conclusion: There was no statistically significant difference between the curative effects of the combined chemotherapy regimen of the new-generation anticancer drugs oxaliplatin and carboplatin. The main toxicity of nedaplatin was myelosuppression and gastrointestinal toxicity. There was no significant difference among the toxicities of the combined chemotherapy of nedaplatin, oxaliplatin, and carboplatin. Thus, any of these drugs can be used to treat advanced gynecological neoplasms based on the specific clinical conditions of patients.