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目的:探讨顺铂+氟尿嘧啶(FP方案)和顺铂+紫杉醇(TP方案)同步放射治疗在早期高危宫颈癌术后的临床疗效和毒性反应。方法:57例经病理学或细胞学确诊的(Ⅰ～Ⅱ)a期高危宫颈癌术后患者,随机分为A组(FP方案同步放化组)31例;B组(TP方案同步放化组)26例。A组:顺铂40mg/m2第1天静脉滴注,氟尿嘧啶1.0mg/m2第(1～5)天静脉滴注,28天为1个周期,共2个周期。B组:紫杉醇135mg/m2,第1天静脉滴注;顺铂40mg/m2,第(1～4)天静脉滴注,28天为1个周期,共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:盆腔外转移率B组低于A组(P<0.05),盆腔内复发率两组相似(P>0.05),3年生存率两组分别为88.4%,70.9%(P<0.05)。两组不良反应相似,但骨髓抑制发生率TP组高于FP组(P<0.05)。结论:早期高危宫颈癌术后FP、TP方案同步放化疗均显示出较高的治疗依从性,TP方案同步放化组较前者在远期疗效中具有生存优势。
Objective: To investigate the clinical efficacy and toxicity of cisplatin plus fluorouracil (FP regimen) and cisplatin plus paclitaxel (TP regimen) in the treatment of early high-risk cervical cancer. Methods: Fifty-seven patients with stage Ⅰ-Ⅱ high-risk cervical cancer diagnosed by pathology or cytology were randomly divided into group A (group FP) and group B (group B) with synchronized radiotherapy Group) 26 cases. Group A: cisplatin 40mg / m2 intravenous drip on the first day, fluorouracil 1.0mg / m2 on the first (1 ~ 5) day intravenous drip, 28 days for a period of 2 cycles. Group B: paclitaxel 135mg / m2, the first day of intravenous infusion; cisplatin 40mg / m2, intravenous drip (1-4 days), 28 days for a period of 2 cycles. The two groups of clinical efficacy and adverse reactions were observed. Results: The pelvic metastasis rate in group B was lower than that in group A (P <0.05). The recurrence rate in pelvic cavity was similar in both groups (P> 0.05). The 3-year survival rate was 88.4% and 70.9% in both groups (P <0.05). Adverse reactions were similar in both groups, but the incidence of myelosuppression in TP group was higher than in FP group (P <0.05). CONCLUSIONS: Both FP and TP radiotherapy and chemotherapy after early postoperative high-risk cervical cancer show high compliance. The TP radiotherapy and concurrent radiotherapy group have the survival advantage over the long-term efficacy.