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山东大学学报(医学版) ›› 2011, Vol. 49 ›› Issue (5): 128-131.

• 论文 • 上一篇    下一篇

局部晚期子宫颈鳞状细胞癌不同组合放化疗疗效的前瞻性比较研究

胡尔西旦·尼牙孜,赵化荣,忙尼沙·阿不都拉,包永星   

  1. 新疆医科大学第一附属医院肿瘤中心, 乌鲁木齐 830054
  • 收稿日期:2011-01-16 出版日期:2011-05-10 发布日期:2011-05-10
  • 通讯作者: 赵化荣。E-mail:xydyfyzhr@163.com
  • 作者简介:胡尔西旦·尼牙孜(1972- ),维吾尔族,医学硕士,主要从事肿瘤的放化疗研究。

A randomized clinical trial in comparison of concurrent single agent cisplatin, cisplatin in combination with 5-fluorouracil and cisplatin in combination  with taxel for locally advanced cervical squamous cell cancer

Niyaz·Hurshidam,  ZHAO Hua-rong,  Abdulla·Mangnisha,  BAO Yong-xing   

  1. Tumor Center,  First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang, China
  • Received:2011-01-16 Online:2011-05-10 Published:2011-05-10

摘要:

目的     前瞻性比较3种不同化疗方案和根治性放射治疗的不同组合方式的同期放化疗疗效、不良反应及对生存的影响。方法    将261例IIB、  IIIA、  IIIB、 ⅣA期的局部晚期宫颈鳞状细胞癌前瞻性随机分入3组:放疗加每周顺铂增敏化疗组(RT+DDP)、放疗加同期5氟脲嘧啶和顺铂(RT+FC)化疗组、放疗加同期紫杉和顺铂(RT+TC)化疗组。放疗均是全程根治性放疗。放疗方法:盆腔外照射45~50Gy,外照射30~40Gy时挡直肠区域;腔内高剂量率Ιγ192后装治疗A点剂量25~36Gy。RT+DDP组中每周顺铂30mg/m2、每周1次,共5~6次;RT+FC和RT+TC组中顺铂75mg/m2,分3d静脉注射,RT+FC组每日缓慢静脉点滴5氟脲嘧啶650mg/m2,连用4d;RT+TC组中紫杉醇135mg/m2静脉点滴,  两药联合化疗在每个患者的整个放疗中完成2周期。结果     完成计划的总病例数为261例,  其中RT+DDP组88例、RT+FC组 89例、RT+TC组84例。3组患者的一般临床特点差异无统计学意义。3组的总生存率差异、近期疗效、直肠和膀胱的3/4级晚期并发症发生率差异亦均无统计学意义(P>0.05); TC+RT组的无病生存率与DDP+RT组比较差异有统计学意义(P<0.017)。结论     RT+DDP、RT+FC、RT+TC治疗局部晚期宫颈鳞状细胞癌疗效均可,患者均可耐受急性不良反应。RT+TC在无病生存方面可能使患者获益。

关键词: 子宫颈鳞状细胞癌;放疗;化疗;治疗结果

Abstract:

Objective     To compare the outcome of the cisplatin-based chemotherapy with 5-fluoracil (RT+FC), taxel (RT+TC) two regimens concurrent chemo-radiotherapy with standard weekly single agent cisplatin and concurrent radiation therapy (RT+DDP). MethodsPatients with locally advanced cervical squamous cell cancer of stage IIB, IIIA,IIIB, and IVA with clinically negative aortic nodes were eligible. Pelvic RT dose was 45-50Gy  and  high -dose rate intracavitary brachytherapy. The standard arm had weekly cisplatin 30mg/m2 per week lasting 5-6 cycles during RT. The experimental arm had cisplatin 75mg/m2/3wk, PVI 5-FU 625mg/m2/d for 4d/3wk in the RT+FC group, and taxel 135mg/m2/3wk in the RT+TC group for 2 cycles during RT. The disease-free survival and overall survival were analyzed. The Short-term efficacy and adverse events were observed. Results    The two experimental groups had improvement in 4-year survival compared with weekly cisplatin during RT. The TC+RT group was better than the  RT+DDP group in disease-free survival. More grades 3-4 neutropenia appeared in the TC+RT group than in the other two groups, whereas less thrombocytopenia, and emesis and diarrhea occurred in the TC+RT group than the FC+RT group.There were no statistic differences of long-time irradiation-related rectum and cystic complication incidences among the three groups. Conclusion    In this study, the three arm treatment models of locally advanced squamous cell carcinoma of cervix were safe and good with tolerable adverse events. Regimen chemotherapy in combination with RT did not show improved overall survival outcome over weekly cisplatin during RT. TC+RT might lead to better disease-free survival.

Key words: Squamous cell carcinoma of cervix; Radiotherapy; Chemotherapy; Treatment outcome

中图分类号: 

  • R737.33
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