紫杉醇联合顺铂新辅助化疗与同步放化疗在局部晚期宫颈癌中的疗效评价
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摘要
目的探讨紫杉醇联合顺铂新辅助化疗与同步放化疗在局部晚期宫颈癌中的临床疗效。方法本研究纳入2009年11月至2017年8月就诊于中国人民解放军总医院第五医学中心的131例均经病理证实为鳞癌的ⅠB2～ⅣA期局部晚期宫颈癌患者,分为观察组:新辅助化疗(NACT)+同步放化疗(CCRT)85例;对照组:单纯同步放化疗46例。对两组进行临床资料统计分析及临床疗效评估。结果 CCRT组年龄大于NACT+CCRT组,差异有统计意义(P <0.05);其他指标两组间差异均无统计学意义(P>0.05)。两组近期有效率、完全缓解、部分缓解、疾病稳定及疾病进展差异均无统计学意义(P>0.05)。NACT+CCRT组的1年无疾病进展期(PFS)为86%(CI 95%78.3～93.7),1年总生存率(OS)为93.7%(CI 95%88.3～99.0),均高于CCRT组,差异有统计意义(P <0.05);NACT+CCRT组的2年PFS和OS分别为:77.8%(CI 95%68.1～87.5)、84.0%(CI 95%75.2～92.8),NACT+CCRT组的3年PFS和OS分别为:73.2%(CI 95%62.1～84.2)、81.6%(CI95%71.9～91.3),经Log Rank检验发现,两组的PFS、OS差异均无统计学意义(P>0.05)。结论紫杉醇联合顺铂新辅助化疗并没有使LACC患者长期总生存额外获益。
Objective To compare the clinical curative effects of neoadjuvant chemotherapy followed by chemoradiation of the patients with locally advanced cervical cancer(LACC). Methods 131 cases of LACC patients(Ⅰ B2～Ⅳ A) were collected in our hospital between Sep.2009 to Aug. 2017, treated with neoadjuvant paclitaxel 175 mg/m2 D1 and cisplatin 50 mg/m~2 D2, for 2 cycles. They were divided into two groups: neoadjuvant chemotherapy(NACT)followed by concurrent chemoradiotherapy(CCRT) group as study group, concurrent chemoradiotherapy group as control group. The clinical curative effects and clinical data were analyzed between two groups. Results The mean age of control group was higher than study group(P <0.05), there was no difference in others indexes. There was no difference in response rate, CR, PR, SD and PD between the two groups. The PFS and OS at 1 year after treatment of study group were 86%(CI95%78.3～93.7) and 93.7%(CI 95%88.3～99.0)respectively, both higher than control group(P <0.05). PFS and OS at 2 and 3 years after treatment of study group were 77.8%(CI 95%68.1～87.5), 84.0%(CI 95%75.2-92.8), 73.2%(CI 95%62.1～84.2),81.6%(CI 95%71.9～91.3)respectively. There were no difference in PFS and OS at 2 and 3 years after treatment between the two groups(P >0.05). Conclusion In our study, NACT in locally advanced cervical cancer patients did not show a meaningful improvement in PFS and OS at 2 and 3 years after treatment.
Objective To compare the clinical curative effects of neoadjuvant chemotherapy followed by chemoradiation of the patients with locally advanced cervical cancer(LACC). Methods 131 cases of LACC patients(Ⅰ B2～Ⅳ A) were collected in our hospital between Sep.2009 to Aug. 2017, treated with neoadjuvant paclitaxel 175 mg/m2 D1 and cisplatin 50 mg/m~2 D2, for 2 cycles. They were divided into two groups: neoadjuvant chemotherapy(NACT)followed by concurrent chemoradiotherapy(CCRT) group as study group, concurrent chemoradiotherapy group as control group. The clinical curative effects and clinical data were analyzed between two groups. Results The mean age of control group was higher than study group(P <0.05), there was no difference in others indexes. There was no difference in response rate, CR, PR, SD and PD between the two groups. The PFS and OS at 1 year after treatment of study group were 86%(CI95%78.3～93.7) and 93.7%(CI 95%88.3～99.0)respectively, both higher than control group(P <0.05). PFS and OS at 2 and 3 years after treatment of study group were 77.8%(CI 95%68.1～87.5), 84.0%(CI 95%75.2-92.8), 73.2%(CI 95%62.1～84.2),81.6%(CI 95%71.9～91.3)respectively. There were no difference in PFS and OS at 2 and 3 years after treatment between the two groups(P >0.05). Conclusion In our study, NACT in locally advanced cervical cancer patients did not show a meaningful improvement in PFS and OS at 2 and 3 years after treatment.
引文
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[2]O Ginsburg,F Bray,MP Coleman,et al.The global burden of women’s cancers:a grand challenge in global health[J].Lancet,2017,389(10071):847-860.
[3]Gong L,Zhang JW,Yin RT,et al.Safety and efficacy of neoadjuvant chemotherapy followed by radical surgery versus radical surgery alone in locally advanced cervical cancer patients[J].Int J Gynecol Cancer,2016,26(4):722-728.
[4]Matsuo K,Machida H,Mandelbaum RS,et al.Validation of the2018 FIGO cervical cancer staging system[J].Gynecol Oncol,2018,10(26):899-997.
[5]Carla Rameri Alexandre Silva de Azevedo,Luiz Claudio Santos Thuler,Maria Julia Goncalves de Mello,et al.,Neoadjuvant chemotherapy followed by chemoradiation in cervical carcinoma[J].Int J Gynecol Cancer,2016,26(12):729-736.