奈达铂同步调强放疗治疗局部晚期宫颈癌的临床研究

目的 比较奈达铂或顺铂同步调强放化疗治疗局部晚期宫颈癌的近期疗效及不良反应。方法 协和医院肿瘤中心2009年8月至2011年8月收治的经病理证实的ⅡB至ⅣA期宫颈癌患者86例，分为奈达铂组和顺铂组。均采用盆腔调强放射治疗联合后装治疗，盆腔放疗大体肿瘤靶区（GTV）剂量56Gy／28f，盆腔淋巴结引流区（CTV）剂量50Gy／28f，后装剂量25～30Gy。奈达铂组：放疗第1天起予奈达铂25mg／m2静滴，每周1次，5～6次；顺铂组：放疗第1天起予顺铂25mg／m2静滴，每周1次，5～6次。结果 两组有效率均达100.0％，奈达铂组的完全缓解率为89.1％，顺铂组为87.5％，差异无统计学意义。奈达铂组食欲减退、恶心、呕吐及体重下降的发生率明显低于顺铂组（P＜0.05），奈达铂组白细胞减少、血小板减少的发生率略高于顺铂组，但差异无统计学意义。两组急性放射性膀胱炎及2级以上放射性直肠炎的发生率均较低。结论 奈达铂或顺铂联合同步调强放疗治疗局部晚期宫颈癌疗效相似，但奈达铂的恶心、呕吐反应较轻，耐受性优于顺铂。

Clinical study of nedaplatin-based concurrent chemoradiation with intensity-modulated radiotherapy for locally advanced cervical cancer

Objective To compare the efficacy and toxicity of concurrent nedaplatin or cisplatin-based chemoradiation for locally advanced cervical cancer.Methods From August 2009 to August 2011,86 cases of cervical cancer pathologically proved from stage ⅡB to stage ⅣA were randomly divided into nedaplatin group and cisplatin group.Patients in both groups were received intensity-modulated radiation of pelvic cavity and brachytherapy.The total dose of gross tumor volume was 56Gy/28f,for clinical target volume 50Gy/28f in IMRT and 25-30Gy in brachytherapy.Patients in nedaplatin/cisplatin group received weekly nedaplatin/cisplatin 25mg/m2began at the d1 of radiotherapy for 5 to 6 times totally.Results The overall response rate of two groups was both 100.0%,and the CR rate（CRR） in nedaplatin group and cisplatin group was 89.1% and 87.5% respectively without significant difference.As to the side-effects,the incidence of anorexia,nausea,vomiting and loss of body weight in nedaplatin group were less than those in cisplatin group with significant difference,while thrombocytopenia and leukopenia was a little higher than that in cisplatin group but without significant difference.The incidence of acute cystitis and rectitis above stage Ⅱ was low.Conclusion The efficacy of concurrent nedaplatin or cisplatin based chemoradiation for locally advanced cervical cancer is similar,however,the nedaplatin group has a lower rate of nausea,vomiting and a better tolerance than the cisplatin group.