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目的比较奈达铂或顺铂同步根治性放疗治疗局部晚期宫颈癌的疗效和安全性。方法回顾性分析2012年1月至2014年1月63例ⅠB_2~ⅣA期宫颈癌患者的临床资料,其中奈达铂同步放疗组29例,顺铂同步放疗组34例。体外照射采用三维适形放疗,总剂量50 Gy/25 f;腔内照射A点后装总剂量30 Gy。顺铂40 mg/m~2静滴,放疗开始后每周1次,共6次。奈达铂40 mg/m~2静滴,放疗开始后每周1次,共6次。结果奈达铂组获CR 19例、PR 9例、PD 1例,有效率(RR)为96.5%;顺铂组获CR 28例、PR 6例,RR为100.0%,两组RR的差异无统计学意义(P>0.05)。奈达铂组2年无复发生存率和2年无转移生存率分别为93.1%和86.2%,顺铂组分别为91.2%和88.2%,差异均无统计学意义(P>0.05)。两组主要不良反应为白细胞减少、血小板减少、恶心呕吐和放射性肠炎。奈达铂组3~4级恶心呕吐的发生率为17.2%,顺铂组为41.1%,差异有统计学意义(P<0.05);其他不良反应发生率的差异均无统计学意义(P>0.05)。结论奈达铂同步放疗治疗中晚期宫颈癌的疗效与顺铂相似,胃肠道反应较顺铂轻,安全性良好。
Objective To compare the efficacy and safety of nedaplatin or cisplatin concurrent radical radiotherapy in the treatment of locally advanced cervical cancer. Methods The clinical data of 63 patients with stage ⅠB_2 ~ ⅣA cervical cancer from January 2012 to January 2014 were retrospectively analyzed. Among them, 29 cases were treated with nedaplatin simultaneous radiotherapy and 34 cases were treated with cisplatin concurrent radiotherapy. In vitro irradiation using three-dimensional conformal radiotherapy, the total dose of 50 Gy / 25 f; A point after intraluminal irradiation with a total dose of 30 Gy. Cisplatin 40 mg / m ~ 2 intravenous infusion, once a week after the start of radiotherapy, a total of 6 times. Nida platinum 40 mg / m ~ 2 intravenous infusion, once a week after the start of radiotherapy, a total of 6 times. Results In the Nida platinum group, CR was found in 19 cases, PR 9 cases and PD in 1 case, the effective rate (RR) was 96.5%. There were 28 cases in the cisplatin group and 6 cases in the PR group. The RR was 100.0% Statistical significance (P> 0.05). The 2-year relapse-free survival rate and 2-year non-metastatic survival rate in the nedaplatin group were 93.1% and 86.2%, respectively, and 91.2% and 88.2% in the cisplatin group, respectively, with no significant difference (P> 0.05). The two major adverse reactions were leukopenia, thrombocytopenia, nausea, vomiting and radiation enteritis. The incidence of grade 3 to grade 4 nausea and vomiting was 17.2% in nedaplatin group and 41.1% in cisplatin group (P <0.05). There was no significant difference in the incidence of other adverse reactions (P> 0.05). Conclusion The efficacy of nedaplatin simultaneous radiotherapy for advanced cervical cancer is similar to that of cisplatin, gastrointestinal reaction is lighter than cisplatin, and it is safe.