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目的比较宫颈癌放化同期治疗过程中,顺铂单药每周方案与多西他赛联合顺铂(TP)方案化疗的急性毒性反应。方法回顾性分析2013年1月至2015年3月,我科收治的180例IB-IVB宫颈癌患者,放疗采用3-DCRT或IMRT技术,1次/d,每周5次。化疗方案如下,顺铂单药组:共81例,化疗剂量40mg/m2,每周1次,放疗期间化疗5~6周期;TP组:共计99例,多西他赛:60mg/m2,注射用顺铂60mg/m2,每3周1次,放疗期间化疗2周期。结果血液学毒性:顺铂单药组,32例患者出现Ⅲ-Ⅳ度骨髓抑制(39.5%);而TP组30例(30.3%),两组患者骨髓抑制发生率及严重程度差异无统计学意义(P=0.192)。而TP组患者的下消化道及泌尿系毒性均高于顺铂单药组。两组患者在放疗总时间差异无统计学意义,两组患者的初步疗效相似(P=0.92,1.0)。结论与单药顺铂每周方案相比,TP方案化疗并没有增加急性毒副反应,患者的耐受性较好。
Objective To compare the acute toxicity of cisplatin monotherapy weekly with docetaxel plus cisplatin (TP) regimen in the treatment of cervical cancer during radiotherapy. Methods A retrospective analysis of 180 IB-IVB cervical cancer patients admitted to our department from January 2013 to March 2015 was performed. The radiotherapy was performed by 3-DCRT or IMRT once a day for 5 times a week. Chemotherapy was as follows: cisplatin monotherapy group: a total of 81 cases, the dose of chemotherapy 40mg / m2, once a week, 5 to 6 cycles of chemotherapy during radiotherapy; TP group: a total of 99 cases, docetaxel: 60mg / m2, Cisplatin 60mg / m2, once every 3 weeks, 2 cycles of chemotherapy during radiotherapy. Results Hematological toxicity: Ⅲ-Ⅳ myelosuppression occurred in 32 patients (39.5%) in cisplatin alone group; 30 patients (30.3%) in TP group had no difference in the incidence and severity of myelosuppression Significance (P = 0.192). The TP group of patients with lower gastrointestinal and urinary tract toxicity were higher than the cisplatin monotherapy group. There was no significant difference between the two groups in the total time of radiotherapy. The initial effect was similar in both groups (P = 0.92, 1.0). Conclusion Compared with the single-drug cisplatin weekly program, TP chemotherapy did not increase the acute toxicity, the patient’s tolerance is better.