不同化疗方案同期联合放疗治疗中晚期宫颈癌的临床观察

目的 探讨紫杉醇脂质体（力扑素）对比顺铂同期联合放疗治疗中晚期宫颈癌的疗效及不良反应。方法 选取45例ⅠB2期以上的局部中晚期宫颈癌患者分为力扑素组（n=26）和顺铂组（n=19）,分别给予力扑素55mg／m2或顺铂30mg/m2每周静滴1次,共5次,两组均同时给予盆腔三维适形放疗（全盆腔总剂量45Gy／25次）或后装治疗（A点剂量30～36Gy／5～6次）,比较两组的疗效及不良反应。结果 45例患者均顺利完成同期放化疗。力扑素组获CR 13例,PR 10例,SD 3例,无PD,有效率（RR）为88.5％;顺铂组获CR 12例,PR 3例,SD 3例,PD 1例,RR为84.2％,两组RR差异无统计学意义（P＞0.05）。力扑素组和顺铂组的1年生存率分别为96.2％和89.5％,1年无进展生存率分别为92.3％和73.7％,两组比较差异无统计学意义（P＞0.05）。不良反应均以1～2级为主,力扑素组的血液学毒性及消化道不良反应均低于顺铂组。结论 对局部中晚期宫颈癌患者采用力扑素或顺铂周化疗方案同期放疗的疗效相当,但力扑素周方案化疗同期联合放疗的不良反应较轻,值得临床推广应用。     

肺癌联合化疗中顺铂或奥沙利铂两组疗效对照研究

目的：观察多西紫杉醇联合顺铂与多西紫杉醇联合奥沙利铂治疗晚期非小细胞肺癌（NSCLC）的近期疗效和毒副作用。方法：118例不能手术或术后复发转移的Ⅲ期-Ⅳ期NSCLC患者随机分组，接受多西紫杉醇联合顺铂或多西紫杉醇联合奥沙利铂方案，化疗2周期-3周期后评价疗效。结果：多西紫杉醇联合顺铂组有效率为49．9％，部分缓解率为44．8％；多西紫杉醇联合奥沙利铂组有效率为48．3％，部分缓解率为45．0％，两组近期疗效比较无统计学意义（P〉0．05）。多西紫杉醇联合顺铂组Ⅲ＋Ⅳ度白细胞下降21例（36．2％），而多西紫杉醇联合奥沙利铂组9例（15％），（P〈0．05）；Ⅲ＋Ⅳ度消化道反应在多西紫杉醇联合顺铂组为12例（20．7％），多西紫杉醇联合奥沙利铂组仅4例（6．7％），（P〈0．05）。多西紫杉醇联合顺铂组发生神经毒性6例（10．3％），多西紫杉醇联合奥沙利铂组55例（91．7％），（P〈0．05）。结论：多西紫杉醇联合顺铂或奥沙利铂是治疗晚期非小细胞肺癌（NSCLC）较有效的方案。     

紫杉醇脂质体联合卡铂治疗晚期卵巢上皮癌的临床分析

目的研究紫杉醇脂质体联合卡铂方案化疗治疗晚期卵巢上皮癌的临床疗效和毒副作用。方法对经减瘤术后病理组织学确诊的Ⅲ一Ⅳ卵巢上皮癌患者26例,采用紫杉醇脂质体联合卡铂方案化疗,其中紫杉醇脂质体130～175mg／m^2第1天静脉滴注;卡铂300mg／m^2第2天静脉滴注,每21天为1个周期,每2个周期评价1次疗效。结果26例患者完全可以评价疗效,其中完全缓解7例,部分缓解11例,稳定6例,进展3例,总有效率为69．23％,其中Ⅲ期有效率为72．22％,Ⅳ期有效率为62．50％。中位疾病进展时间（MTYP）10个月（5～13个月）,无复发生存期5个月。毒副作用主要为骨髓抑制和胃肠道反应。结论紫杉醇脂质体联合卡铂方案治疗晚期卵巢上皮癌近期疗效好,毒副作用可以耐受,值得临床推广使用。     

不同剂型紫杉醇联合顺铂治疗晚期非小细胞肺癌的效果分析

目的 探讨不同剂型紫杉醇联合顺铂治疗晚期非小细胞肺癌（NSCLC）的临床疗效。方法选取本院2014年1月至2016年1月收治的晚期NSCLC患者共90例,根据紫杉醇剂型分为3组,其中紫杉醇组31例接受紫杉醇联合顺铂治疗,脂质体紫杉醇组27例接受脂质体紫杉醇联合顺铂治疗,白蛋白结合型紫杉醇组32例接受白蛋白结合型紫杉醇联合顺铂治疗,2个周期后采用RECIST 1.0评价各组的近期疗效,采用NCI-CTC AE（3.0版）分级标准评价毒副作用,根据随访资料比较3组的无进展生存期（PFS）。结果全组患者均可评价近期疗效。紫杉醇组、脂质体紫杉醇组和白蛋白结合型紫杉醇组的有效率分别为16.1％、18.5％和21.9％,疾病控制率分别为87.1％、92.6％和93.8％,三组有效率和疾病控制率的差异均无统计学意义（P＞0.05）;紫杉醇组、脂质体紫杉醇组和白蛋白结合型紫杉醇组的中位PFS分别为9.0、10.0和12.0个月,差异无统计学意义（P＞0.05）;脂质体紫杉醇组和白蛋白结合型紫杉醇组的恶心呕吐和肌肉／关节痛的总发生率分别为44.4％和34.4％、18.5％和12. 5％,均低于紫杉醇组,差异有统计学意义（P＜0.05）。结论 不同剂型紫杉醇联合顺铂治疗晚期NSCLC的疗效相当,但脂质体紫杉醇和白蛋白结合型紫杉醇的毒副反应较轻,可作为年龄较大、一般状况较差患者的治疗方案。     

紫杉醇脂质体联合顺铂、替加氟二线治疗转移性食管癌26例

[目的]探讨紫杉醇脂质体联合顺铂、替加氟作为二线方案治疗转移性食管癌的疗效和安全性。[方法]26例转移性食管癌患者使用紫杉醇脂质体80mg／m^2静脉滴注3h，d1.8；顺铂20mg／m^2，静脉滴注，d1-3；甲酰四氢叶酸200mg／m^2，静脉滴注2h，d1-3替加氟600mg／m^2，静脉滴注，d1-3；28d为1个周期。[结果]26例患者共完成99周期化疗，平均3．81个周期。8周后复查CT结果显示：完全缓解（CR）2例（7．7％），部分缓解（PR）9例（34．6％），稳定（SD）8例（30．8％），进展（PD）7例（26．9％），有效率（RR）为42．3％（11／26），疾病控制率73．1％（19／26）。中位疾病进展时间（TTP）为4．8个月（95％可信区间，2．8～8．2月），中位生存期（MST）为8．4个月（95％可信区间，4．1～13．2月），1年生存率为11．5％（3／26）。毒性反应较小，主要是中性粒细胞减少。[结论]紫杉醇脂质体联合顺铂、替加氟作为二线方案治疗转移性食管癌具有较好的疗效和安全性。     

精确放疗同步含顺铂方案化疗治疗局部晚期食管鳞癌的临床分析

目的 分析局部晚期食管鳞癌进行精确放疗同步顺铂或顺铂联合紫杉醇脂质体化疗的临床疗效及不良反应。方法 收集精确放疗同步含顺铂方案化疗的局部晚期食管鳞癌46例,其中单药顺铂化疗（RT+P组）26例,顺铂联合紫杉醇脂质体化疗（RT+TP组）20例。回顾性分析两种同步放化疗方法的近期疗效,1、2及3年生存率以及放射性食管炎、放射性肺炎、胃肠道反应、骨髓抑制等不良反应发生率,并与同期17例单纯放疗（RT组）病例进行比较。结果 三组患者观察期内均未出现Ⅳ~Ⅴ级不良反应。三组仅12%~15%的患者出现Ⅰ~Ⅱ级放射性肺炎,发生率低、程度轻,三组相互间差异无统计学意义（P=0.939）。RT组的Ⅰ~Ⅱ级胃肠道反应发生率及Ⅲ级骨髓抑制发生率均明显低于其他组。同步放化疗组的治疗有效率高于单纯放疗组,但差异无统计学意义（P=0.161）。同步放化疗组总的1、2、3年生存率及中位生存期均高于单纯放疗组。RT+TP组的生存率明显优于RT组（P=0.019）。结论 精确放疗同步顺铂联合紫杉醇脂质体化疗治疗局部晚期食管鳞癌,具有较好的近期疗效及生存获益,明显优于单纯放疗。     

紫杉醇脂质体与紫杉醇治疗62例非小细胞肺癌的疗效分析

[目的]比较注射用紫杉醇脂质体与普通紫杉醇治疗非小细胞肺癌的疗效及毒副反应。[方法]非小细胞肺癌患者62例随机分为试验组和对照组。试验组（31例）给紫杉醇脂质体每次剂量135mg／m^2；对照组（31例）给紫杉醇每次剂量135mg／m^2。两组均联合顺铂治疗，每3周重复1次为1周期，共2周期。[结果]入组62例患者中，有60例患者毒副反应和疗效可供评价。试验组有效率27．0％，对照组有效率17．0％，两组疗效差异无统计学意义（P〉0．05）。在血液学毒性方面，两组发生率差异无统计学意义（P〉0．05）。在溶媒所产生的相关毒性方面．试验组发生率明显低于对照组，差异有统计学意义（P〈0．05）。[结论]紫杉醇脂质体联合顺铂治疗非小细胞肺癌效果良好，两种紫杉醇的疗效相当，但其溶媒所产生的皮疹等过敏反应．紫杉醇脂质体明显低于紫杉醇，其余毒副反应相仿。     

同期单药铂类化疗联合放疗治疗食管癌

目的评价同期单药铂类化疗联合放疗治疗食管癌的临床疗效。方法2008年4月至2010年2月治疗食管癌患者47例,采用常规分割放射治疗,200cGy／次,1次／d,5d／周,放疗总量6000～7000cGy。同期化疗采用奈达铂（31例）或顺铂（16例）20mg／m^2,1次／周。结果近期有效率达97．87％,不良反应骨髓抑制以Ⅰ-Ⅱ度为主,采用奈达铂和顺铂联合放疗差异兀统计学意义（x^2=1．09,P=0．30）。结论同期单药铂类化疗联合放疗治疗食管癌近期疗效较好,不良反直小。     

多西紫杉醇联合顺铂治疗晚期乳腺癌临床观察

[目的]观察多西紫杉醇联合顺铂治疗晚期乳腺癌的临床疗效及毒副反应。[方法]23例晚期乳腺癌采用多西紫杉醇75mg／m^2，静脉滴注1h，d1；顺铂25mg／m^2，静脉滴注，d1～3；21d为1个周期，至少治疗2个周期。[结果]全组23例中，CR4例，PR12例，SD4例，PD3例，有效率69．6％（16／23）。毒副反应主要为白细胞减少，Ⅰ＋Ⅱ度占60．8％。[结论]多西紫杉醇联合顺铂治疗晚期乳腺癌有一定疗效。毒副反应轻，可以耐受。     

同步放化疗治疗Ⅲ期非小细胞肺癌28例的临床分析

目的探讨同步放化疗治疗Ⅲ期非小细胞肺癌（NSCLC）的近期疗效、不良反应及可行性。方法对28例ⅢA和ⅢB期NSCLC患者,采用多西紫杉醇联合顺铂的化疗方案,其中多西紫杉醇为35mg／m^2、顺铂25mg／m^2,于放疗的第1天开始,每周1次,连续进行,每周复查血常规和肝功能;放疗结束14天后继续化疗,多西紫杉醇95mg／m^2第1天,顺铂75mg／m^2分3天给予,第1、2、3天。放疗采用三维适形放疗,胸部照射2Gy／次,5次／周,共6～7周,中位剂量为60Gy。结果总有效率为78．6％（22／28）,1、2、3年生存率分别为57．1％（16／28）、35．7％（10／28）和17．8％（5／28）,中位生存期为11．6～22个月。结论对Ⅲ期非小细胞肺癌,采用同步放化疗治疗可获得较好的近期疗效和1、2、3年生存率。不良反应可以耐受,值得临床推广。     

放射治疗同时化疗Ⅲ期非小细胞肺癌

目的 评价放射治疗结合不同化疗方案治疗不能手术的Ⅲ期非小细胞肺癌（NSCLC）疗效。方法 62例不能手术的Ⅲ期NSCLC患者随机分为2个组：29例每周接受1次紫杉醇30mg、顺铂30mg化疗（紫杉醇组）,33例每周接受1次依托泊甙（VP-16）100mg、顺铂30mg化疗（VP-16组）。连续5～6周,均同时配合常规分割放射治疗（2Gy/次,5次/周）,照射野包括肺部原发灶和纵隔淋巴引流区,总剂量为60～70Gy。结果 紫杉醇组总有效（CR PR）为82.8%,完全缓解（CR）率为10.3%,VP-16组总有效率为54.6%,CR率为18.0%。2个组总有效率差异有显著性意义(X^2=4.41,P=0.038）。中位生存期、1、2年生存率紫杉醇组分别为12.8个月、52.2%、27.3%,VP-16组分别为9.8月、42.8%、18.4%,2个组差异无显著性意义。化疗的毒副作用主要是骨髓抑制和消化道反应,但均可耐受。结论 紫杉醇组治疗不能手术的Ⅲ期NSCLC近期有效率明显优于VP-16组,但不提高生存率。     

Phase III randomized trial of doxorubicin + cisplatin versus doxorubicin + 24-h paclitaxel + filgrastim in endometrial carcinoma: a Gynecologic Oncology Group study.

BACKGROUND: This study was performed to determine whether 24-h paclitaxel plus doxorubicin and filgrastim was superior to cisplatin plus doxorubicin in patients with endometrial cancer with respect to response, progression-free survival (PFS) and overall survival (OS). PATIENTS AND METHODS: Eligible chemotherapy-na?ve patients were randomly assigned to doxorubicin 60 mg/m2 intravenously (i.v.) followed by cisplatin 50 mg/m2 i.v. (arm 1, n=157) or doxorubicin 50 mg/m2 i.v. followed 4 h later by paclitaxel 150 mg/m2 i.v. over 24 h plus filgrastim 5 microg/kg on days 3-12 (arm 2, n=160). Starting doses were reduced for prior pelvic radiotherapy and age > 65 years. Both regimens were to be repeated every 3 weeks for a maximum of seven cycles. RESULTS: There was no significant difference in response rate (40% versus 43%), PFS (median 7.2 versus 6 months) or OS (median 12.6 versus 13.6 months) for arm 1 and arm 2, respectively. Toxicities were primarily hematological, with 54% (arm 1) and 50% (arm 2) of patients experiencing grade 4 granulocytopenia. Gastrointestinal toxicities were similar in both arms. CONCLUSIONS: Doxorubicin and 24-h paclitaxel plus filgrastim was not superior to doxorubicin and cisplatin in terms of response, PFS or survival in advanced endometrial cancer.     

Comparison of concurrent chemoradiotherapy with cisplatin plus 5-fluorouracil versus cisplatin plus paclitaxel in patients with locally advanced cervical carcinoma

Objective

The aim of this study was to compare survival outcomes and toxicities between concurrent radiotherapy with cisplatin plus 5-fluorouracil and that with cisplatin plus paclitaxel in patients with locally advanced cervical carcinoma.

Methods

We retrospectively reviewed data from 93 locally advanced cervical carcinoma patients (stage IB to IVA) who had been treated by concurrent radiotherapy with cisplatin plus 5-fluorouracil (CF, n=45) vs. cisplatin plus paclitaxel (CP, n=48) as primary therapy. Toxicities and survival outcomes were compared.

Results

In the CP group, there were higher frequencies of severe (grade 3 or 4) leukopenia (79.2%, as compared to 11.1% in the CF group), severe neutropenia (77.1%, as compared to 8.9% in the CF group) and severe peripheral neuropathy (12.5%, as compared to 2.2% in the CF group). In the CF group, there were higher frequencies of severe nausea (33.3%, as compared to 14.6% in the CP group) and severe hyponatremia (11.1%, as compared to 0% in the CP group). Five-year DFS of the CF and CP groups was 67.4% and 79.1%, respectively (p=NS). Five year OS of the CF and CP groups was 79.6% and 80.9%, respectively (p=NS).

Conclusion

Concurrent radiotherapy with cisplatin plus paclitaxel showed increased leukopenia, neutropenia and peripheral neuropathy, but less gastrointestinal toxicity (nausea) than that with cisplatin plus 5-fluorouracil. Survival outcome between these two groups was not statistically different in this study. Large prospective randomized controlled studies will be needed to confirm this result.     

炎性乳腺癌术前适形放疗联合紫杉醇周剂量同步化疗疗效观察

目的观察术前适形放疗联合紫杉醇单药周剂量同步化疗炎性乳腺癌的疗效。方法19例炎性乳腺癌术前采用三维适形放疗联合紫杉醇单药30mg/（m2·w）每周同步化疗。结果全组总有效率、完全缓解率和部分缓解率分别为89．5％、21．1％、68．4％,1、2、3年生存率分别为89．5％、73．7％和57．9％,中位生存时间44月,中位肿瘤进展时间29月。接受手术治疗的3年生存率达到76．9％;未接受手术治疗的无3年以上生存率,两者之间比较差异有统计学意义（χ2=14．1008,P=0．0002）。严重者副反应（3度＋4度）少见。结论术前适形放疗联合紫杉醇单药每周同步化疗炎性乳腺癌疗效较好。     

Paclitaxel-Loaded Polymeric Micelle (230 mg/m2) and Cisplatin (60 mg/m2) vs. Paclitaxel (175 mg/m2) and Cisplatin (60 mg/m2) in Advanced Non–Small-Cell Lung Cancer: A Multicenter Randomized Phase IIB Trial

IntroductionThe development of paclitaxel-loaded polymeric micelle (PPM) has circumvented many of the infusion-related difficulties associated with standard solvent-based paclitaxel. PPM plus cisplatin combination chemotherapy showed significant antitumor activity in phase I and II studies. This prospective randomized controlled phase IIB study assessed the noninferiority of the efficacy and tolerability of high-dose PPM plus cisplatin to a standard dose of paclitaxel plus cisplatin.Patients and MethodsPatients with stage IIIB/IV or recurrent non–small-cell lung cancer (NSCLC) who were chemonaive were eligible for participation. The patients were randomly assigned to receive PPM 230 mg/m² plus cisplatin 60 mg/m² or paclitaxel 175 mg/m² plus cisplatin 60 mg/m² once every 3-week cycle. The primary endpoint was to compare the response rate (RR) between the groups with coprimary analyses to assess noninferiority. Secondary endpoints included progression-free survival, overall survival, and safety.ResultsA total of 276 patients were randomized to PPM plus cisplatin (n = 140) or paclitaxel plus cisplatin (n = 136). RR was 43.6% in the PPM plus cisplatin group and 41.9% in the paclitaxel plus cisplatin group. Noninferiority of PPM plus cisplatin compared with paclitaxel plus cisplatin was confirmed for RR. There were no differences in progression-free survival and overall survival between the groups. Although there was a higher rate of grade 3 neutropenia in the PPM plus cisplatin group, the overall rate of adverse events was comparable between the 2 groups.ConclusionPPM in combination with cisplatin was well tolerated, and its response rate was noninferior to that of paclitaxel plus cisplatin in patients with advanced NSCLC and who were chemonaive.     

Phase III study comparing cisplatin plus fluorouracil to paclitaxel, cisplatin, and fluorouracil induction chemotherapy followed by chemoradiotherapy in locally advanced head and neck cancer.

PURPOSE: To compare the antitumor activity and toxicity of the two induction chemotherapy treatments of paclitaxel, cisplatin, and fluorouracil (FU; PCF) versus standard cisplatin and FU (CF), both followed by chemoradiotherapy (CRT), in locally advanced head and neck cancer (HNC). PATIENTS AND METHODS: Eligibility criteria included biopsy-proven, previously untreated, stage III or IV locally advanced HNC. Patients received either CF (cisplatin 100 mg/m2 on day 1 plus FU 1000 [corrected] mg/m2 continuous infusion on days 1 through 5) or PCF (paclitaxel 175 mg/m2 on day 1, cisplatin 100 mg/m2 on day 2, and FU 500 mg/m2 continuous infusion on days 2 through 6); both regimens were administered for three cycles every 21 days. Patients with complete response (CR) or partial response of greater than 80% in primary tumor received additional CRT (cisplatin 100 mg/m2 on days 1, 22, and 43 plus 70 Gy). RESULTS: A total of 382 eligible patients were randomly assigned to CF (n = 193) or PCF (n = 189). The CR rate was 14% in the CF arm v 33% in the PCF arm (P < .001). Median time to treatment failure was 12 months in the CF arm compared with 20 months in the PCF arm (log-rank test, P = .006; Tarone-Ware, P = .003). PCF patients had a trend to longer overall survival (OS; 37 months in CF arm v 43 months in PCF arm; log-rank test, P = .06; Tarone-Ware, P = .03). This difference was more evident in patients with unresectable disease (OS: 26 months in CF arm v 36 months in PCF arm; log-rank test, P = .04; Tarone-Ware, P = .03). CF patients had a higher occurrence of grade 2 to 4 mucositis than PCF patients (53% v 16%, respectively; P < .001). CONCLUSION: Induction chemotherapy with PCF was better tolerated and resulted in a higher CR rate than CF. However, new trials that compare induction chemotherapy plus CRT versus CRT alone are needed to better define the role of neoadjuvant treatment.     

Chemotherapy for gastric cancer that recurs after adjuvant chemotherapy with S-1

We retrospectively analyzed the efficacy of chemotherapy in patients whose gastric cancer recurred after adjuvant chemotherapy with S-1. A total of 51 patients were evaluated. Twenty-one patients received S-1-containing chemotherapy as first-line treatment after recurrence [cohort A: S-1 plus cisplatin (n = 10), S-1 monotherapy (n = 7), S-1 plus irinotecan (n = 3) and S-1 plus docetaxel (n = 1)]. The other 30 patients received a non-S-1-containing regimen [cohort B: paclitaxel or docetaxel (n = 22), irinotecan plus cisplatin (n = 6) and other drugs (n = 2)]. No objective responses occurred in cohort A, while five patients achieved a partial response in cohort B (response rate, 0 versus 16%; P = 0.04). Median progression-free survival was significantly longer in cohort B than in cohort A (4.3 versus 2.3 months, P = 0.02). S-1-containing chemotherapy does not appear to be effective in patients whose gastric cancer recurs after adjuvant S-1 chemotherapy. Other chemotherapeutic agents should be evaluated in this setting.     

Temozolomide (TMZ) combined with cisplatin (CDDP) in patients with brain metastases from solid tumors: a Hellenic Cooperative Oncology Group (HeCOG) Phase II study

PURPOSE: To evaluate the efficacy of temozolomide (TMZ) combined with cisplatin (CDDP) in terms of response rate, time to progression (TTP) and overall survival (OS), as well as the tolerability of the regimen in patients with brain metastases from solid tumors. PATIENTS AND METHODS: Patients (n=32) with brain metastases were treated with TMZ 150 mg/m2/day (chemotherapy-pretreated) or 200 mg/m2/day (chemotherapy-naive) for 5 days, combined with CDDP 75 mg/m2 on day 1, every 28 days. Primary tumor sites included breast cancer (n=15), lung cancer (n=12) and other (n=5). Twenty-seven patients had received prior chemotherapy for extracranial disease and 17 had prior radiotherapy to the brain. RESULTS: One patient (3.1%) with non-small cell lung cancer (NSCLC) achieved complete response. Nine patients (28.1%; six with breast cancer, two with melanoma and one with NSCLC) achieved a partial response and five patients (16%) had stable disease. Median OS was 5.5 months and median TTP 2.9 months. One patient died from septicemia/neutropenic fever. Grade III-IV toxicities included anemia (9%), leukopenia (6%), thrombocytopenia (3%), renal toxicity (3%), headache (3%), fatigue (3%), nausea (3%), vomiting (3%), and alopecia (6%). CONCLUSIONS: TMZ combined with CDDP is an active and well-tolerated combination in patients with brain metastases from solid tumors.     

紫杉醇脂质体联合铂类同步放化疗治疗宫颈癌的随机对照研究

目的 评价紫杉醇脂质体联合铂类同步放化疗治疗宫颈癌的疗效和安全性.方法 对162例 Ⅱa～Ⅳ期宫颈癌患者进行随机对照研究.紫杉醇联合铂类组(对照组)71例,紫杉醇135 mg/m2,第1天;顺铂80 mg/m2或卡铂[曲线下面积(AUC)取值4～6],第2天.紫杉醇脂质体联合铂类组(试验组)91例,紫杉醇脂质体135 mg/m2,第1天;顺铂80 mg/m2或卡铂(AUC取值4～6),第2天.两组均3周为1个疗程,共治疗2～3个疗程.两组均同期予以根治性放疗.同步放化疗结束后6个月,根据肿瘤退缩情况判定疗效,并持续进行随访.结果 试验组和对照组的有效率分别为89.0%和90.1%,差异无统计学意义(P＞0.05).试验组和对照组的1年累积生存率分别为89.2%和91.4%,差异亦无统计学意义(P＞0.05).试验组的胃肠道反应、骨髓抑制、肌肉和关节酸痛、皮疹发生率分别为49.6%、78.0%、26.3%和4.4%,显著低于对照组(63.3%、81.6%、53.5%和12.6%,均P＜0.05),而脱发、肝功能损害、外周神经炎等方面差异并不明显(P＞0.05).结论 紫杉醇脂质体联合铂类同步放化疗治疗Ⅱa～Ⅳ期宫颈癌安全、有效,远期疗效有待进一步观察.

Abstract：

Objective To compare the efficacy, side effects and influence of two chemotherapy regimens, paclitaxel liposome combined with platinum and paclitaxel combined with platinum, on the survival rate in patients with cervical carcinoma receiving concurrent chemoradiotherapy. Methods One hundred and sixty two cases with primary cervical carcinoma diagnosed and treated in the Jiangxi Maternal and Children Hospital between January 2008 and November 2009 were enrolled in this randomized controlled trial. Seventy one cases were included in the paclitaxel group and 91 in the paclitaxel liposome group. The chemotherapy doses were as followings: paclitaxel liposome and paclitaxel 135 mg/m2;cisplatin 80 mg/m2 or carboplatin AUC 4-6, repeated every 21 days for two or three times. Radical radiotherapy was given to both groups at the same time. The efficacy was evaluated by the tumor regression and the patients were followed-up for six months. Results The overall response rates of paclitaxel group and paclitaxel liposome group were 90.1% and 89.0%, respectively (P>0.05). The 1-year cumulative survival rate was 91.4% for the paclitaxel group and 89.2% for the paclitaxel liposom group (P>0.05). The incidence rate of adverse effects such as rash, gastrointestinal toxicity, bone marrow suppression and muscle/joint pain in the paclitaxel liposome group was significantly lower than that in the paclitaxel group (P<0.05), while there was no significant difference regarding the hair loss, liver damage, and peripheral neuritis (P>0.05). Conclusions Paclitaxel liposome plus platinum is a safe and effective therapeutic regimen for stage Ⅱa-Ⅳ cervical carcinoma. However, the long-term efficacy of this regimen should be further observed.     

紫杉醇联合顺铂治疗48例蒽环类耐药性晚期乳腺癌

目的：观察紫杉醇联合顺铂方案治疗蒽环类耐药性晚期转移性乳腺癌(MBC)的疗效与不良反应。方法：2000年3月～2002年10月。采用紫杉醇联合顺铂方案治疗蒽环类耐药性MBC48例。全组化疗共144个周期。中位周期数为3(2。5)个。结果：CR6例，PR21例，SD12例，PD9例，总有效率(CR PR)56．2％。全组中位缓解期6．5(2～12)个月，中位TTP为7．6(2～14)个月，主要剂量毒性为骨髓抑制，胃肠道反应和关节肌肉疼痛。骨髓抑制以白细胞减少为主，Ⅲ～Ⅳ度白细胞减少的发生率为18．7％。结论：紫杉醇联合顺铂方案治疗蒽环类耐药性MBC有较好的疗效且不良反应可以耐受。