宋鹏慧, 武建军, 汪关雨, 陈建兵. TP方案联合同步放疗治疗中晚期宫颈癌疗效及安全性的研究[J]. 国际放射医学核医学杂志. DOI: 10.3760/cma.j.cn121381-202305022-00394
引用本文: 宋鹏慧, 武建军, 汪关雨, 陈建兵. TP方案联合同步放疗治疗中晚期宫颈癌疗效及安全性的研究[J]. 国际放射医学核医学杂志. DOI: 10.3760/cma.j.cn121381-202305022-00394
Penghui Song, Jianjun Wu, Guanyu Wang, Jianbing Chen. Study on the efficacy and safety of TP regimen combined with concurrent chemoradiotherapy in the treatment of advanced cervical cancer[J]. Int J Radiat Med Nucl Med. DOI: 10.3760/cma.j.cn121381-202305022-00394
Citation: Penghui Song, Jianjun Wu, Guanyu Wang, Jianbing Chen. Study on the efficacy and safety of TP regimen combined with concurrent chemoradiotherapy in the treatment of advanced cervical cancer[J]. Int J Radiat Med Nucl Med. DOI: 10.3760/cma.j.cn121381-202305022-00394

TP方案联合同步放疗治疗中晚期宫颈癌疗效及安全性的研究

Study on the efficacy and safety of TP regimen combined with concurrent chemoradiotherapy in the treatment of advanced cervical cancer

  • 摘要:
    目的 评估TP方案(紫杉醇+顺铂联合化疗)联合同步放疗治疗中晚期宫颈癌的疗效和安全性。
    方法 选取2020年8月至2021年8月于长治医学院附属和平医院接受治疗的60例女性中晚期宫颈癌患者进行前瞻性研究,年龄42~69(52.2±3.2)岁。采用随机数字表法将患者分为对照组30例(顺铂化疗同步放疗)和观察组30例(紫杉醇+顺铂化疗同步放疗),比较2组患者的临床疗效、血清肿瘤标志物水平、不良反应发生率、细胞凋亡和细胞外基质降解相关指标水平。符合正态分布的计量资料的组间比较采用t检验(方差齐),计数资料的组间比较采用χ2检验。
    结果 观察组患者的客观缓解率高于对照组86.67%(26/30)对 63.33%(19/30),差异有统计学意义(χ2=4.355,P<0.05)。观察组患者治疗后的鳞状细胞癌抗原(2.18±0.68) μg/L对(4.06±1.12) μg/L和糖类抗原(CA)125(22.24±5.93)U/ml对 (26.28±6.71)U/ml水平均低于对照组患者治疗后,且差异均有统计学意义(t=7.858、2.471,均P<0.05)。观察组与对照组患者乏力3.33%(1/30)对6.67%(2/30)、骨髓抑制6.67%(2/30) 对 3.33%(1/30)、胃肠道反应6.67%(2/30) 对10.00%(3/30)、放射性肠炎6.67%(2/30) 对3.33%(1/30)、泌尿系统反应3.33%(1/30) 对 6.67%(2/30)、肝肾功能损伤发生率3.33%(1/30)对10.00%(3/30)的差异均无统计学意义(χ2=0.218~1.071,均P>0.05)。与对照组患者治疗后比较,观察组患者治疗后基质金属蛋白酶(MMP)-2和MMP-9水平均降低(522.47±45.93) ng/L对(325.41±32.54) ng/L,(516.28±45.84) ng/L对(378.18±33.59) ng/L,半胱氨酸蛋白酶-8(Caspase-8)水平升高 (96.48±9.33) ng/L对(219.49±33.88) ng/L,且差异均有统计学意义(t=19.175、13.310、19.172,均P<0.001)。
    结论 TP方案联合同步放疗可提高中晚期宫颈癌患者的客观缓解率,治疗后鳞状细胞癌抗原和CA 125水平降低,MMP-2、MMP-9水平降低,Caspase-8水平升高。TP方案联合同步放疗具有良好的安全性。

     

    Abstract:
    Objective To evaluate the efficacy and safety of TP regimen (paclitaxel and cisplatin combined chemotherapy) combined with concurrent radiotherapy in the treatment of advanced cervical cancer.
    Methods A prospective study was conducted on 60 female patients with advanced cervical cancer, aged (52.2±3.2) years, who were treated in Heping Hospital Affiliated to Changzhi Medical College from August 2020 to August 2021. Patients were divided into control group 30 cases (cisplatin chemotherapy and radiotherapy) and observation group 30 cases (paclitaxel+cisplatin chemotherapy and radiotherapy) by random number table method. The clinical efficacy, serum tumor marker levels, incidence of adverse reactions, apoptosis and extracellular matrix degradation of patients in the two groups were compared. The t test (homogeneity of variance) was used to compare the measurement data conforming to the normal distribution, and the χ2 test was used to compare the counting data.
    Results The objective remission rate of the observation group was higher than that of the control group (86.67% (26/30) vs. 63.33% (19/30)), and the difference was statistically significant (χ2=4.355, P<0.05). The levels of squamous cell carcinoma antigen and carbohydrate antigen (CA) 125 in the observation group were lower than those in the control group after treatment (2.18±0.68) μg/L versus (4.06±1.12) μg/L, (22.24±5.93) U/ml versus (26.28±6.71) U/ml. Fatigue (3.33%(1/30) vs. 6.67%(2/30)), myelosuppression (6.67%(2/30) vs. 3.33%(1/30)), gastrointestinal reaction (6.67% (2/30) vs. 10.00%(3/30)), radiation enteritis (6.67%(2/30) vs. 3.33%(1/30)) and urinary reaction (3.33% (1/30) vs. 6.67%(2/30)) and the incidence of liver and kidney function injury (3.33%(1/30) vs. 10.00%(3/30)) were not statistically significant (χ2=0.218-1.071, all P>0.05). Compared with the control group after treatment, the levels of matrix metalloproteinase(MMP)-2 ((522.47±45.93) ng/L vs. (325.41±32.54) ng/L) and MMP-9 ((378.18±33.59) ng/L vs. (516.28±45.84) ng/L) in the observation group were decreased. The level of cysteine proteinase-8 (Caspase-8) ((219.49±33.88) ng/L vs. (96.48±9.33) ng/L) was increased, and the differences were statistically significant (t=19.175, 13.310, 19.172; all P<0.05).
    Conclusions TP regimen combined with synchronous radiotherapy can improve the objective remission rate of patients with advanced cervical cancer. After treatment, the levels of squamous cell carcinoma antigen and CA125, MMP-2, MMP-9 and Caspase-8 were decreased. TP regimen combined with synchronous radiotherapy has good safety.

     

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