摘要
目的探讨洛铂和顺铂分别联合紫杉醇治疗局部晚期宫颈癌的近远期疗效及对患者血清肿瘤标志物及诱捕受体3(DcR3)、凋亡抑制基因(Survivin)水平的影响。方法选择资阳市第一人民医院局部晚期宫颈癌患者90例作为研究对象,采用随机数字表法分为观察组和对照组,各45例。观察组采用TL方案(紫杉醇+洛铂),对照组采用TP方案(紫杉醇+顺铂)。比较两组近期疗效,分析治疗前后血清细胞角蛋白19片段抗原(CYFRA21-1)、鳞状细胞癌抗原(SCCAg)及DcR3、Survivin水平,观察两组毒副反应发生情况及随访结果。结果观察组疾病控制率、总反应率分别为97.78%、82.22%,对照组分别为95.56%、68.89%,差异均无统计学意义(P>0.05)。治疗后两组血清CYFRA21-1、SCCAg、DcR3、Survivin均显著低于治疗前(P<0.05),但观察组上述指标与对照组比较差异无统计学意义(P>0.05)。观察组消化道反应发生率为24.44%,显著低于对照组的57.78%(P<0.05),而肝肾功能损伤、周围神经炎、骨髓抑制、脱发发生率与对照组比较差异无统计学意义(P>0.05)。所有患者治疗后均随访3~60个月,观察组5年累积生存率为64.44%,对照组5年累积生存率为60.00%,差异无统计学意义(P>0.05)。结论TL方案治疗局部晚期宫颈癌近远期疗效与TP方案相似,但前者毒副反应发生率更低,值得临床积极推广。
Objective To investigate the short-term and long-term effects of lotplatin and cisplatin combined with paclitaxel in the treatment of locally advanced cervical cancer,and the effects of lotplatin and cisplatin combined with paclitaxel on serum tumor markers,decoy receptor 3(decoy receptor3,DcR3)and apoptosis suppressor gene(Survivin)levels.Methods 90 patients with locally advanced cervical cancer were randomly divided into observation group and control group,45 cases in each group.The observation group was treated with TL regimen(paclitaxel+lobaplatin),and the control group was treated with TP Regimen(paclitaxel+cisplatin).The short-term efficacy of the two groups was compared,and the serum levels of cyfra21-1,SCCAg,DcR3 and Survivin were analyzed before and after treatment to observe the occurrence of adverse reactions and the follow-up results.Results The disease control rate(DCR)and overall response rate(ORR)of the observation group were 97.78%and 82.22%,respectively,and the DCR and ORR of the control group were 95.56%and68.89%,respectively,and there were no statistically significant differences(P>0.05),The levels of CYFRA21-1,SCCAg,DcR3 and Survivin in the two groups were significantly lower than those before treatment(P<0.05),but there were no significant differences between the two groups(P>0.05).The incidence of digestive tract reaction in the observation group was 24.44%,significantly lower than 57.78%of the control group(P<0.05),but there was no significant differences in the incidences of liver and kidney function injury,peripheral neuritis,bone marrow suppression,and alopecia compared with the control group(P>0.05).All patients were followed up for 3 to 60 months after treatment.The 5-year cumulative survival rate of the observation group was 64.44%,and that of the control group was 60.00%,the difference was not statistically significant(P>0.05).Conclusion The short-term and long-term efficacy of TL regimen in the treatment of locally advanced cervical cancer was similar to that of TP Regimen,but the former had a lower incidence of adverse reactions,which was worthy of clinical promotion.
作者
蒋艳
黎雪梅
涂春燕
刘守福
JIANG Yan;LI Xue⁃mei;TU Chun⁃yan;LIU Shou⁃fu(Department of Obstetrics and Gynecology,the First People's Hospital of Ziyang City,Ziyang,Sichuan 641300,China)
出处
《热带医学杂志》
CAS
2022年第4期563-567,共5页
Journal of Tropical Medicine
基金
四川省科技厅科技支撑项目(2018FZ165337)
关键词
洛铂
顺铂
紫杉醇
局部晚期宫颈癌
诱捕受体3
Lobaplatin
Cisplatin
Paclitaxel
Locally advanced cervical cancer
Decoy receptor 3
作者简介
蒋艳(1985-),女,硕士,主治医师,研究方向:妇科肿瘤;通信作者:刘守福,E⁃mail:125177208@qq.com
