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目的对比观察调强适形放疗分别序贯紫杉醇脂质体与紫杉醇治疗复发性宫颈癌的近期疗效和不良反应。方法将61例复发宫颈癌患者分为试验组和对照组。2组调强适形放疗均应用6MV、X线直线加速器,设立5～7个共面照射野,肿瘤剂量45～50 GY。放疗后,试验组(n=31)d 1予紫杉醇脂质体135 mg.m-2静脉滴注(静滴),d 2卡铂350 mg.m-2静滴。对照组(n=30)d 1予紫杉醇135 mg.m-2静滴,d 2卡铂350 mg.m-2静滴。21 d为一个周期,2个周期后评价疗效。结果试验组完全缓解(CR)率为6%,部分缓解(PR)率为68%,有效(CR+PR)率74%。对照组CR率7%,PR率63%,有效率为70%,2组比较差异无显著意义(P>0.05)。2组患者骨髓抑制、放射性直肠炎、放射性膀胱炎的发生率无显著差异(P>0.05)。试验组患者肌肉痛、面色潮红、皮疹的发生率低于对照组,差异有显著意义(P<0.05)。结论调强适形放疗序贯紫杉醇脂质体、卡铂方案化疗治疗复发性宫颈癌与序贯紫杉醇、卡铂方案化疗的近期有效率相当,但不良反应轻。
Objective To compare the short-term effects and side effects of sequential conformal radiotherapy with sequential paclitaxel liposomes and paclitaxel in the treatment of recurrent cervical cancer. Methods 61 cases of recurrent cervical cancer patients were divided into experimental group and control group. In both groups, 6MV and X-ray linear accelerator were used to establish conformal radiotherapy. Five to seven co-planar irradiation fields were established. The tumor dose was 45-50 Gy. After radiotherapy, the experimental group (n = 31) d 1 was treated with paclitaxel liposome 135 mg.m-2 intravenously (intravenous drip) and d 2 carboplatin 350 mg.m-2 intravenously. The control group (n = 30) d 1 received intravenous infusion of paclitaxel 135 mg.m-2 and d 2 carboplatin 350 mg.m -2 intravenous infusion. 21 d for a cycle, two cycles after the evaluation of efficacy. Results The complete remission (CR) rate was 6%, the partial remission (PR) rate was 68% and the effective (CR + PR) rate was 74%. In the control group, the CR rate was 7%, the PR rate was 63% and the effective rate was 70%. There was no significant difference between the two groups (P> 0.05). There was no significant difference in the incidence of bone marrow suppression, radiation proctitis and radiation cystitis among the two groups (P> 0.05). The incidence of muscular pain, flushing and rash in the test group was lower than that in the control group, with significant difference (P <0.05). Conclusions Tight-conditioning conformal radiotherapy with sequential paclitaxel liposomes, carboplatin chemotherapy in the treatment of recurrent cervical cancer and sequential paclitaxel, carboplatin chemotherapy in the near future, but the rate of adverse reactions.