紫杉醇联合卡铂化疗同步放疗对中晚期宫颈癌的疗效及对SCCAg、CYFRA21-1抗原的影响

Effectiveness of paclitaxel combined with carboplatin chemotherapy and radiotherapy in treatment of advanced cervical cancer and its effect on SCCAg and CYFRA21-1

  • 摘要: 目的 探究紫杉醇与卡铂联合化疗同步放疗对中晚期宫颈癌的临床疗效及对鳞状上皮癌抗原(squamous cell carcinoma antigen,SCCAg)和角质蛋白19片段抗原21-1(CYFRA21-1)的影响。 方法 选取2011年2月- 2013年2月青岛市市立医院收治的中晚期宫颈癌患者62例,将入选患者按治疗方式分为对照组和治疗组,每组各31例。对照组给予单纯放疗,观察组在放疗基础上行同步化疗。对比两组临床疗效、SCCAg和CYFRA21-1含量变化、不良反应发生率和预后。 结果 两组在年龄、病理学分类、FIGO分期及是否绝经方面差异无统计学意义。治疗后对照组总有效率为54.84%(17/31),观察组为83.87%(26/31),差异有统计学意义(P=0.013)。治疗前对照组和观察组SCCAg分别为(2.04±0.41)μg/ml和(2.13±0.23)μg/ml,CYFRA21-1分别为 (2.89±0.67)μg/ml和 (3.01±0.42)μg/ml,差异均无统计学意义。治疗后两组 SCCAg(1.46±0.34)μg/ml vs (0.99±0.24)μg/ml、CYFRA21-1(1.63±0.37)μg/ml vs (1.02±0.31)μg/ml均低于治疗前 (P均< 0.05),且观察组均低于对照组(P均< 0.05);对照组和观察组不良反应发生率分别为80.65%(25/31)、35.48%(11/31)(P< 0.05);随访60个月后,对照组生存率为3.23%(1/31),观察组生存率为22.58%(7/31),差异有统计学意义(P=0.014)。 结论 紫杉醇联合卡铂化疗同步放疗对中晚期宫颈癌患者疗效明显,可降低SCCAg、CYFRA21-1表达水平,安全性好。

     

    Abstract: Objective To investigate the effectiveness of paclitaxel combined with carboplatin chemotherapy and radiotherapy in the treatment of advanced cervical cancer and its effect on squamous cell carcinoma antigen (SCCAg) and cytokeratin 19 fragmen 21-1(CYFRA21-1). Methods From February 2011 to February 2013, 62 patients with moderate and advanced cervical cancer treated in Qingdao Municipal Hospital were selected and divided into two groups according to different treatment methods, with 31 cases in each group. Patients in control group were treated with radiotherapy alone, while the observation group was treated with synchronous chemoradiotherapy. The clinical effectiveness, the changes of SCCAg and CYFRA21-1, the incidence of adverse reactions and the prognosis of the two groups were compared. Results There was no significant difference in age, pathological classification, FIGO stage, and menopausal status between the two groups. The total effective rate was 54.84% (17/31) in the control group and 83.87%(26/31) in the observation group, with statistically significant difference (P=0.013). After treatment, SCCAg and CYFRA21-1 in control group were significantly higher than observation group (SCCAg, 1.46±0.34 vs 0.99±0.24) μg/ml and (CYFRA21-1, 1.63±0.37 vs 1.02±0.31) μg/ml, and they decreased compared to those before treatment (all P< 0.05). The incidence rates of adverse reactions in the control group and the observation group were 32.26% (10/31) and 35.48% (11/31) (P=0.788). After 60-month follow-up, the survival rate was 3.23% (1/31) in the control group , significantly lower than 22.58% (7/31) in the observation group(P=0.014). The local recurrence rate and distant metastasis rate in the observation group were lower than those in the control group(all P< 0.05). Conclusion Paclitaxel combined with carboplatin chemotherapy and radiotherapy can down-regulate expression level of SCCAg and CYFRA21-1, which is an effective and safe way for moderate and advanced cervical cancer.

     

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