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目的探讨小剂量紫杉醇联合卡铂治疗晚期宫颈癌的疗效及安全性。方法收集2012年3月~2015年3月间在本院接受治疗的晚期宫颈癌患者224例,根据随机对照法分为低剂量组和高剂量组,各112例。低剂量组给予紫杉醇60 mg·m~(-2)、卡铂60 mg·m~(-2)静脉滴注;高剂量组给予紫杉醇135 mg·m~(-2)、卡铂60 mg·m~(-2)静脉滴注,两组均连续治疗2疗程。治疗结束后评估两组患者的治疗效果和毒副反应,治疗后3月,采用欧洲癌症研究与治疗组织(EORT)的生命质量核心量表(QLQ-C30)评估两组患者的近期生存质量,随访1~2年。结果治疗2疗程后,两组患者的治疗效果差异无统计学意义,低剂量组客观缓解率(ORR)与高剂量组相比差异无统计学意义(P>0.05);鳞癌患者ORR高于腺癌(P<0.05);低剂量组血液系统毒副反应、非血液系统毒副反应发生率均低于高剂量组(P<0.05)。治疗后3月,低剂量组QLQ-C30总分,躯体功能、角色功能、情绪功能、认知功能、社会功能等子量表评分值均高于高剂量组(P<0.05)。两组患者治疗1年、2年生存率以及2年后复发率无显著差异(P>0.05)。结论不同剂量紫杉醇治疗晚期宫颈癌的疗效相似,小剂量紫杉醇治疗后毒副作用较轻、患者近期生存质量较高。
Objective To investigate the efficacy and safety of low-dose paclitaxel combined with carboplatin in the treatment of advanced cervical cancer. Methods A total of 224 patients with advanced cervical cancer who were treated in our hospital from March 2012 to March 2015 were divided into two groups according to randomized control: low-dose group and high-dose group, with 112 cases in each group. The low dose group was given paclitaxel 60 mg · m -2 and carboplatin 60 mg · m -2 intravenously. The high dose group was given Paclitaxel 135 mg · m -2 and carboplatin 60 mg · m ~ (-2) intravenous drip, two groups were treated for 2 courses. After treatment, the therapeutic effects and side effects of the two groups were evaluated. Three months after the treatment, the quality of life of the two groups was assessed using the Quality of Life Core Scale (QLQ-C30) from the European Organization for Research and Treatment of Cancer (EORT) Follow-up 1 to 2 years. Results After 2 courses of treatment, there was no significant difference in therapeutic effect between the two groups. There was no significant difference in the objective response rate (ORR) between the two groups (P> 0.05). The ORR in patients with squamous cell carcinoma was higher than Adenocarcinoma (P <0.05). The incidences of hematological toxicity and non-hematological toxicities in low dose group were lower than those in high dose group (P <0.05). After 3 months of treatment, QLQ-C30 score, body function, role function, emotional function, cognitive function, social function and other subscales scores of low-dose group were higher than those of high-dose group. There was no significant difference in the 1-year, 2-year survival rates and recurrence rates after 2 years in both groups (P> 0.05). Conclusion Different doses of paclitaxel for the treatment of advanced cervical cancer have similar efficacy. The low dose of paclitaxel has less side effects and higher quality of life in recent years.