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目的探讨杉醇联合铂类方案治疗中晚期宫颈癌患者的临床疗效及其对血清CYFRA21-1、SCCAg的影响。方法选取2011年3月至2012年2月四川绵阳四○四医院收治的中晚期宫颈癌患者72例,按照化疗方法分成观察组和对照组各36例,观察组采用紫杉醇+顺铂(TP)方案,对照组采用紫杉醇+卡铂(TC)方案,观察两组临床疗效和血清CYFRA21-1、SCCAg变化。结果观察组近期总有效率为91.7%,对照组为94.4%,两组比较差异无统计学意义(P>0.05);两组3年总生存率、局部复发率、远处转移率分别为63.9%和61.1%、13.8%和11.1%、36.1%和33.3%,比较差异无统计学意义(P>0.05);两组治疗后血清CYFRA21-1、SCCAg均有明显下降(P<0.05),但两组下降水平比较无明显差异(P>0.05);两组患者不良反应主要为肾功能损害、消化道反应、骨髓抑制、神经毒性和脱发,观察组不良反应发生率明显高于对照组(P<0.05)。结论杉醇联合铂类方案治疗中晚期宫颈癌疗效显著,其中TP和TC方案疗效相当,但是TC方案不良反应发生少,患者依从性好。
Objective To investigate the clinical efficacy of paclitaxel combined with platinum regimen in the treatment of patients with advanced cervical cancer and its effect on serum CYFRA21-1 and SCCAg. Methods Seventy-two patients with advanced cervical cancer who were treated in 440 Hospital of Mianyang, Sichuan Province from March 2011 to February 2012 were divided into observation group (36 cases) and control group (36 cases) according to the chemotherapy method. The observation group was treated with paclitaxel + cisplatin (TP) Program, the control group using paclitaxel + carboplatin (TC) program to observe the clinical efficacy and serum CYFRA21-1, SCCAg changes. Results The total effective rate was 91.7% in the observation group and 94.4% in the control group, with no significant difference between the two groups (P> 0.05). The overall 3-year survival rate, local recurrence rate and distant metastasis rate were 63.9 % And 61.1%, 13.8% and 11.1%, 36.1% and 33.3%, respectively. There was no significant difference between the two groups (P> 0.05). The serum levels of CYFRA21-1 and SCCAg were significantly decreased in both groups (P <0.05) There was no significant difference between the two groups (P> 0.05). Adverse reactions in the two groups were mainly renal dysfunction, gastrointestinal reaction, myelosuppression, neurotoxicity and hair loss. The incidence of adverse reactions in the observation group was significantly higher than that in the control group <0.05). Conclusion Cisplatin combined with platinum regimen has a significant therapeutic effect on advanced cervical cancer. The efficacy of TP and TC regimen is quite good, but there are fewer side effects of TC regimen and good compliance of patients.