摘要
目的:探讨不同新辅助化疗(NACT)治疗局部晚期宫颈癌(LACC)的疗效及安全性。方法:选取于本院收治的LACC患者68例,根据化疗方案的不同分为观察组(n=34)和对照组(n=34)。观察组采用多西他赛+奥沙利铂(DTX+OXA)化疗方案,对照组采用紫杉醇+顺铂(TAX+DDP)化疗方案,21d为1周期,共治疗2个周期,治疗结束后行腹腔镜广泛子宫切除术+盆腔淋巴结清扫术+腹主动脉旁淋巴结取样术。观察两组近期疗效及不良反应发生情况;对两组术后标本进行病理学评估;检测并比较两组外周血T淋巴细胞亚群及NK细胞变化。结果:观察组ORR和DCR分别为47.09%、91.18%,对照组分别为44.12%、85.29%,两组间无显著性差异(P>0.05)。与治疗前比较,治疗后两组CD4^+、CD8^+及NK细胞比例均显著降低,CD4^+/CD8^+比值明显增加(P<0.01),但两组间无显著性差异(P>0.05)。术后经病理学检测两组PCR、PR1、PR2患者比例无显著性差异(P>0.05);同时宫颈浸润深度、外科切缘、宫旁浸润及盆腔淋巴结转移情况均无显著性差异(P>0.05)。观察组脱发、胃肠道反应、肾脏毒性患者比例低于对照组(P<0.05);但周围神经毒性患者比例高于对照组(P<0.05或P<0.01)。结论:腹腔镜术前应用DTX+OXA及TAX+DDP化疗方案治疗LACC近期疗效相当,但DTX+OXA方案对患者总体毒性反应相对较低,安全性好,值得临床推荐使用。
Objective::To explore the efficacy and safety of different neoadjuvant chemotherapy(NACT)to treat cerical cervical cancer(LACC).Methods:68cases of LACC treated in the hospital from April2015to August2016were divided into observation groups(n=34)and control group(n=34).Observation group USES the west he plus oxaliplatin into more chemotherapy regimens(DTX+OXA),control group adopts paclitaxel+cisplatin chemotherapy regimens(TAX+DDP)and21d of1cycle,a total of treatment2cycles,end of the treatment after laparoscopic extensive hysterectomy,pelvic lymph node cleaning operation and the lymph node sampling technique by abdominal aorta.Observation of the recent results of the two groups and the adverse reactions;Pathological evaluation of the postoperative specimens of the two groups;Two groups of peripheral blood T lymphocyte subgroups and NK cell changes were detected and compared.Results:the observation group ORR and DCR were47.09%,91.18%,and the control group was44.12%,85.29%,and no significant difference between the two groups(P>0.05).Compared with before treatment,after treatment for2set of CD4+,CD8+and NK cells were significantly reduced,CD4+/CD8+ratio increased significantly(P<0.01),but there was no significant difference between two groups(P>0.05).There was no significant difference in the proportion of patients with PCR,PR1,PR2,and PR2after postoperative pathology(P>0.05).At the same time,there was no significant difference between cervical infiltration depth,surgical incisiveness,and palatial infiltration and pelvic lymph node metastasis(P>0.05).The percentage of patients with baldness,gastrointestinal reaction and renal toxicity was lower than the control group(P<0.05).But the ratio of peripheral neurotoxicity was higher than the control group(P<0.05or P<0.01).Conclusions:laparoscopic surgery using DTX+OXA LACC and TAX+DDP chemotherapy regimen for the recent curative effect,but DTX+OXA solution general toxic effects on the patients is relatively low,good security,worth clinical it is recommended to use.
作者
刘玉娜
贺鹏
韩文红
陈丽
LIU Yu na;HE Peng;HAN Wen hong;CHEN Li(Baoding First Central Hospital in Hebei Province, Baoding City, Hebei Province, 071028, China;No. 252 Hospital of PLA, Baoding City, Hebei Province, 071000, China)
出处
《海南医学院学报》
CAS
2017年第18期2566-2569,共4页
Journal of Hainan Medical University
基金
2016年保定市科学技术研究与发现指导计划项目(16ZF103)~~
关键词
局部晚期宫颈癌
新辅助化疗
多西他赛
奥沙利铂
免疫功能
Cervical cervical cancer
Neoadjuvant chemotherapy
Dorsey him
Oxaliplatin into
The immune function
