卡铂放射增敏治疗子宫颈癌68例临床报告
Carboplatin as Radiosensitizer to Treat Cervical Cancer in 68 Cases
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摘要: 目的：研究卡铂作为放射增敏剂在晚期宫颈癌中的作用。方法：1990~1992年我院收治ⅡB期及ⅢB期子宫颈癌118例，非随机分组，研究组68例：鳞癌63例，腺癌5例，对照组50例：鳞癌47例，腺癌3例，两组病理类型及临床分期均无显著差异，且放射治疗方法相同。研究组每次腔内治疗当天上午卡铂50mg静滴，下午行后装治疗，总量400~500mg。结果：5年生存率各为66.1%(45/68)及66%(33/50)(P>0.05)，差异无显著意义。结论：探讨原因如下：1．每天一次给药，致血药浓度不能恒定；2．剂量太小；3．卡铂静滴与后装治疗间隔时间太长，另外理论上化疗加速残留肿瘤细胞增殖及克隆重组。临床有待解决问题：1．选择有效剂量而副作用可被接受；2．给药合适时间；3．如何序贯。Abstract: One hundred and eighteen patients of stage Ⅱ B / Ⅲ B cervical cancer were treated in our hospital between 1990 and 1992, an unradomized trial was designed to evaluate carboplatin as a radiosensitizer in advanced cervical cancer, research group 68 cases (squamous carcinoma 63 cases, adnocarcinoma 5 cases), control group 50 cases (squamous carcinoma 47 cases, adnocarcinoma 3 cases), patients of research group received intravenous carboplatin in the morning at the dose 50mg, brachtherapy was administered in the afternoon, the total dose is 400～500mg. The 5 year survival rate is 66 1%(45/68) and 66%(33/50) ( P 0 05), there is no significant difference. The reason may be as follows: 1.carboplatin administered once a week made concentration of blood can't be constant; 2.the dose was too low; 3.the period between carboplatin intravenous and brachtherapy was too long. Besides, therotically chemotherapy can make residual tumor cell accelerate reproduction and clone reconstitute. The problem remains to be resolved in clinic: 1.select effective dose and reduce endurable side effect; 2.the suitable time to give carboplatin; 3.the proper order between carboplatin and brachtherapy.
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Key words:
- cervical cancer /
- carboplation /
- radiosensitizer
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1 楼洪坤，楼寒梅.卡铂与放射联合治疗宫颈癌，中华肿瘤杂志，1997，19(4)：286 2 Muderspach LI, Curtin JP, Roman LD, etal. Carboplatin as a radiation Sensitizer in locally advanced Cervical Cancer: a pilot study. Gynecol Oncol, 1997,65:336 3 Corn BW, Hernandez E, Anderson L, etal. Phase Ⅰ/Ⅱ stndy of concomitant irradiation and Carboplatin for locally advanced carcinoma of the uterine cervix: a interim report. Am J Clin Oncol. 1996,19(3):317 4 Pekkola-Heino K, Kulmala J, Grenman K. Carboplatin-Radiation interaction in squamons cell carcinoma cell lines. Arch Otolaryngol Head Neck Surg. 1992,118:1312 5 Tseng ChJ, Chang ChT, Lai ChH, etal. A Rahnomized trial of concnrrent chemoradiotherapy versus radiotherapy in advanced corcinoma of the uterine cervix. Gynecol Oncol.1997,66:52
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