紫杉醇联合洛铂治疗局部晚期宫颈癌患者的疗效观察

摘要

目的 探讨紫杉醇联合洛铂在局部晚期宫颈癌(LACC)患者术前新辅助化疗中的效果.方法 选取在该院实施新辅助化疗的58例LACC患者进行研究,其中29例患者(A组)采用紫杉醇联合洛铂新辅助化疗方案,29例患者(B组)采用紫杉醇联合顺铂治疗.两组患者均实施根治性宫颈癌手术治疗.对比两组患者治疗后的近期疗效、血清肿瘤标记物水平、毒副反应发生率及远期预后.结果 A组患者的缓解率82.76％,总有效率100.00％;B组患者的缓解率68.97％、总有效率96.55％,两组间比较差异无统计学意义(P＞0.05);化疗后,A组和B组患者的血清细胞角蛋白19片段抗原21-1、鳞状上皮癌抗原水平较化疗前均明显降低(P＜0.05).化疗过程中,A组患者的恶心呕吐、腹泻发生率分别为17.24％、6.90％,B组患者的恶心呕吐、腹泻发生率分别为48.28％、31.03％,两组比较差异有统计学意义(P＜0.05).随访36个月,A组总生存率为68.97％,B组患者的总生存率为62.07％,两组比较差异无统计学意义(x2=0.305,P=0.581);两组患者的生存函数曲线分析,生存时间比较差异无统计学意义(Z=0.381,P=0.537).结论 紫杉醇联合洛铂在LACC患者术前新辅助化疗中与紫杉醇联合顺铂的效果相当.%Objective To investigate the effect of paclitaxel combined with platinum on neoadjuvant chemotherapy in patients with locally advanced cervical cancer (LACC).Methods A total of 58 cases with LACC were treated with neoadjuvant chemotherapy in our hospital were selected,of which 29 patients (group A) were treated with paclitaxel plus lobaplatin and 29 patients (group B) were treated with paclitaxel plus cisplatin.Both groups received Radical cervical cancer surgery.The short-term efficacy,serum tumor markers,incidence of toxic side effects and long-term prognosis were compared between the two groups.Results The remission rate in group A was 82.75 ％ and the total effective rate was 100.00％;the remission rate in group B was 68.97％ and the total effective rate was 96.55％;there was no significant difference between the two groups (P＞0.05).After chemotherapy,serum CYFRA21-1 and SCCAg levels in patients of group A and B were significantly lower than those before chemotherapy (P＜0.05).During chemotherapy,the incidence of nausea,vomiting and diarrhea in group A was 17.24％ and 6.90 ％,respectively.The incidence of nausea,vomiting and diarrhea in group B was 48.28％ and 31.03 ％,respectively,the difference between the two groups was statistically significant (P＜0.05).After 36 months of follow-up,the overall survival rate in group A was 68.97 ％,and the overall survival rate in group B was 62.07 ％,there was no significant difference between the two groups (x2 =0.305,P =0.581);there was no significant difference in survival time between the two groups (Z=0.381,P=0.537).Conclusion The effect of Paclitaxel combined with lobaplatin in the preoperative neoadjuvant chemotherapy of LACC patients is equivalent to paclitaxel and cisplatin.