目的 探讨奈达铂联合甲地孕酮同步放化疗治疗中晚期宫颈癌的近期疗效.方法 42例中晚期(Ⅱb～Ⅳa期)宫颈癌患者随机分为单纯放疗组(RT组,21例),奈达铂联合甲地孕酮同步放疗组(RT+C组,21例),两组放疗方法相同.RT+C组在放疗开始后,每周1次奈达铂30 mg/m2,静脉滴注,第1天,共4～5周,并常规给予止吐药物及适当水化,患者从治疗开始均每天服用甲地孕酮160mg至治疗结束.结果 RT+C组患者中,完全缓解(CR)17例(81.0%),部分缓解(PR)4例(19.0%),有效率为100%;RT组患者中,CR 8例(38.1%),PR 9例(42.9%),有效率81.0%.RT+C组的CR及有效率均高于RT组,差异有统计学意义.RT+C组患者的1年生存率为100%(21/21),RT组患者的1年生存率为81.0%(17/21),差异有统计学意义(x2=4.42,P＜0.05).结论 奈达铂联合甲地孕酮同步放化疗可提高中晚期宫颈癌的近期疗效,虽毒性反应有所增加,但患者可以耐受.%Objective To investigate the early efficacy of nedaplatin combined with megestrol in concurrent chemoradiotherapy for advanced cervical cancer. Methods Forty-two cases of cervical cancer (FIGO Ⅱb to Ⅳa) were divided randomly into two groups: radiotherapy alone (21 cases) and radiation plus chemotherapy (Nedaplatin) group. The same radiotherapy was given to the two groups. Patients of the RT + C group received nedaplatin 30 mg/m2 in intravenous drip infusion once weekly on day 1, for 4 to 5 weeks, and megestrol 160 mg orally every day during the radiation therapy. Results The early outcome:the complete remission rate was 81.0% and partial remission rate was 19.0% in the RT + C group,significantly better than the CR (38.1%) and PR (42.9%) in the RT group. The 1-year survival rates in the two groups were 100% (21/21) and 81.0% ( 17/21 ), respectively, with a significant difference between the two groups ( P ＜ 0.05 ). Conclusions The combination of nedaplatin and megestrol with concurrent chemoradiotherapy can improve the early outcome of advanced cervical cancer, with somewhat increased but tolerable adverse effects.
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