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

宋鹏慧; 武建军; 汪关雨; 陈建兵

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

摘要:
目的评估紫杉醇+顺铂联合化疗（简称TP）方案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（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（TP方案同步放疗），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的水平。计量资料的组间比较采用t检验，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%对63.33%），且差异有统计学意义（χ²=4.355，P=0.037）。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、骨髓抑制、胃肠道反应、放射性肠炎、泌尿系统反应和肝肾功能损伤的发生率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方案联合同步放疗能够提高中晚期宫颈癌患者的疗效，且具有良好的安全性。

Abstract:
Objective To evaluate the efficacy and safety of paclitaxel and cisplatin combined chemotherapy (TP) regimen 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. The patients were divided into a control group (30 cases of cisplatin chemotherapy and radiotherapy) and an observation group (30 cases of TP regimen and radiotherapy) using the random number table method. The clinical efficacy, serum tumor marker levels, incidence of adverse reactions, apoptosis, and extracellular matrix degradation levels were compared between the two groups. T test was used to compare the measurement data, and χ² test was applied to compare the counting data.
Results The objective remission rate of the observation group was higher than that of the control group (86.67% vs. 63.33%), and the difference was statistically significant (χ²=4.355, P=0.037). The levels of squamous cell carcinoma antigen and carbohydrate antigen 125 in the observation group were lower than those in the control group after treatment ((2.18±0.68) μg/L vs. (4.06±1.12) μg/L, (22.24±5.93) U/mL vs.(26.28±6.71) U/mL), and the differences were statistically significant (χ²=7.858, 2.471; both P<0.05). No statistically significant differences were observed for fatigue, myelosuppression, gastrointestinal reaction, radiation enteritis, and urinary reaction and the incidence of liver and kidney function injury (χ²=0.218−1.071, all P>0.05).compared with patients of the control group after treatment, the levels of matrix metalloproteinase-2 ((522.47±45.93) ng/L vs. (325.41±32.54) ng/L) and MMP-9((516.28±45.84) ng/L vs. (378.18±33.59) ng/L) decreased and the level of cysteine proteinase-8 ((96.48±9.33) ng/L vs. (219.49±33.88) ng/L) increased in the observation group, and the differences were statistically significant (t=19.175, 13.310, 19.172; all P<0.05).
Conclusions The TP regimen with concurrent radiotherapy can improve the efficacy of patients with advanced cervical cancer and has good safety.

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