FP与DP方案同步放化疗治疗中晚期宫颈癌的临床疗效比较

摘要

目的 探讨顺铂+氟尿嘧啶(FP方案)和顺铂+多西紫杉醇(DP方案)同步放射治疗和化学治疗(放、化疗)中晚期宫颈癌的临床疗效和毒性反应.方法 125例经病理学或细胞学确诊的Ⅱb～Ⅳa期宫颈癌患者,随机分为FP组65例及DP组60例.FP组:顺铂40 mg·(m2)-1第1～4天静脉滴注,氟尿嘧啶1.0 mg·(m2)-1第1～5天静脉滴注,28 d为1 个周期,共用2个周期.DP组:多西紫杉醇135 mg·(m2)-1,第1天静脉滴注;顺铂40 mg·(m2)-1,第1～4天静脉滴注,28 d为1个周期,共用2个周期.对两组的临床疗效和不良反应进行对比观察.结果 FP组近期有效率为78.5%,DP组为91.7%,两组差异有统计学意义(P＜0.05).FP组和DP组中位生存时间分别为32.4和31.7个月,2 a生存率分别为84.6%和86.7%,差异无统计学意义(P＞0.05).两组不良反应相似,均以骨髓抑制、胃肠道反应为主,发生率及程度差异无统计学意义(P＞0.05),可耐受.结论 FP方案和DP方案治疗中晚期宫颈癌均具有较好的耐受性和疗效,不良反应可以耐受.DP方案近期效果较FP方案更好,缓解率更高,可作为中晚期宫颈癌较理想的化疗方法之一.%Objective To study the clinic effect and toxic action of program FP ( cisplatin and fiuorouracil ) and DP ( cisplatin and docetaxel ) in synchronization with radiotherapy.Methods One hundred and twenty-five women diognosed as Ⅱ b ～ Ⅳ a stage cervix cancer by pathology and cytology were studied,whom were divided randomly into two groups, the FP group with 65 patients and DP group with 60 patients.The FP group were treated with cisplatin 40 mg· ( m2 ) -1 via vein from the first to fourth day, and with 5-fiurouracil 1.0 mg· ( m2 ) -1 via vein from the first to fifth day,28 days as a course of treatment, for totally two courses.The DP group were treated with docetaxel 135 mg· ( m2 ) -1 via vein in the first day,and cisplatin 135 mg· ( m2 )-1 from day one to four, 28 days as a course and two courses were concluded.The clinic effect and toxic action were tested in comtrast with each other.Results The short-term efficacy of FP group was 78.5％ , and that of DP group was 91.7％ , the difference between two groups showed statistic significance( P＜0.05 ).The meso-positions of FP and DP were 32.4 months and 31.7 months,two-year survival rate were 84.6％ and 86.7％ , respectively, in which no statistic significance( P＞0.05 ) was showed.The toxic action in two groups was similar, the main of which were endurable gastrointestinal reaction and myelosupression, and there was no statistic significance( P＞0.05 ) in the incidence and degree.Conclusion Both FP and DP have a good tolerance and achieve curative effect for patients with medium-and adavanced cervical cancer.DP program has a better immdiate effect and higher relief rate, which could be regarded as a ideal chemotherapy for patients with medium-and adavanced cervix cancer.