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目的探究并评价伊立替康及紫杉醇分别与顺铂合用在宫颈癌新辅助化疗(NACT)中的实效性和安全性。方法选择2012年10月至2014年3月间接受NACT的宫颈癌患者84例,随机分为IP组和TP组各42例。IP组行伊立替康联合顺铂的化疗方案,TP组行紫杉醇联合顺铂的化疗方案,两组均在化疗结束后2~3周行手术治疗。对两组患者近期疗效进行评价,分析两组化疗后不良反应发生情况及术后病理检查结果。结果 IP组缓解率为47.6%(20/42),TP组缓解率为81.0%(34/42),两组差异有统计学意义(P<0.05)。IP组腹泻和骨髓抑制发生率分别为76.2%(32/42)和57.1%(24/42),TP组腹泻和骨髓抑制发生率分别为28.6%(12/42)和83.3%(35/42),差异有统计学意义(P<0.05)。术后病理检查显示,IP组宫旁累积率和淋巴结阳性率分别为33.3%(14/42)和30.9%(13/42),TP组分别为19.0%(8/42)和14.3%(6/42),差异有统计学意义(P<0.05)。结论紫杉醇联合顺铂的化疗方案在宫颈癌NACT中有更加明显的优势。
Objective To investigate and evaluate the efficacy and safety of irinotecan and paclitaxel combined with cisplatin in neoadjuvant chemotherapy for cervical cancer (NACT). Methods Eighty-four patients with cervical cancer who underwent NACT between October 2012 and March 2014 were randomly divided into IP group and TP group, 42 cases each. IP group chemotherapy with irinotecan combined with cisplatin, TP group chemotherapy with cisplatin and paclitaxel chemotherapy, two groups were 2 to 3 weeks after the end of chemotherapy surgery. The short-term efficacy of the two groups of patients were evaluated, the incidence of adverse reactions after chemotherapy and postoperative pathological examination results were analyzed. Results The remission rate of IP group was 47.6% (20/42), and the remission rate of TP group was 81.0% (34/42). There was significant difference between the two groups (P <0.05). The incidence of diarrhea and myelosuppression in IP group were 76.2% (32/42) and 57.1% (24/42), respectively. The incidences of diarrhea and myelosuppression in TP group were 28.6% (12/42) and 83.3% (35/42) ), The difference was statistically significant (P <0.05). Postoperative pathological examination showed that the rate of paracolostomy and lymph node positive rate in IP group were 33.3% (14/42) and 30.9% (13/42) respectively, and those in TP group were 19.0% (8/42) and 14.3% (6) / 42), the difference was statistically significant (P <0.05). Conclusion The chemotherapy regimen of paclitaxel combined with cisplatin has more obvious advantages in cervical cancer NACT.