目的 探討紫杉醇聯(lián)合奈達(dá)鉑或卡鉑在上皮性卵巢癌化療中的療效，為臨床上有效安全的化療方案的選擇提供參考依據(jù)。方法 選取于2011年3月—2013年8月上海交通大學(xué)附屬第六人民醫(yī)院收治的卵巢癌患者102例，隨機(jī)分為治療組（n=51）和對照組（n=51），治療組第1天給予紫杉醇注射液175 mg/m²，加入500 mL生理鹽水中靜脈滴注，3 h內(nèi)滴完，第2天給予注射用奈達(dá)鉑100 mg/m²進(jìn)行靜脈滴注。對照組第1天紫杉醇用法用量同治療組，第2天給予注射用卡鉑400 mg/m²進(jìn)行靜脈滴注。28 d為一個療程，所有患者化療1～6個療程，平均3個療程。治療結(jié)束后，比較兩組的療效和毒副作用。結(jié)果 治療組和對照組治療有效率分別為64.71%、60.78%，兩組比較差異無統(tǒng)計學(xué)意義。治療過程中兩組患者均可發(fā)生血紅蛋白減少、中性粒細(xì)胞減少、白細(xì)胞減少、血小板減少、皮疹、脫發(fā)、惡心嘔吐、肝功能和神經(jīng)感覺異常的毒副作用，其中兩組患者發(fā)生脫發(fā)的發(fā)生率均為100%，血紅蛋白減少、中性粒細(xì)胞減少、白細(xì)胞減少、惡心嘔吐的發(fā)生率均在50%以上。治療組患者沒有發(fā)生發(fā)熱、過敏的毒副作用，神經(jīng)感覺異常的發(fā)生率也低于對照組，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 紫杉醇聯(lián)合奈達(dá)鉑或卡鉑治療上皮性卵巢癌的臨床療效無差異，主要毒副作用為骨髓抑制和胃腸道反應(yīng)。臨床醫(yī)生可根據(jù)患者自身耐受情況、經(jīng)濟(jì)條件進(jìn)行合理選擇化療方案，有利于減少患者化療痛苦，提高患者依從性。

Objective To explore the efficacy of taxinol combined with nedaplatin or carboplatin in treatment of epithelial ovarian cancer, and to provide the reference for effective and safe selection of chemotherapy regimens. Methods Epithelial ovarian cancer patients (102 cases) who came to the Sixth Affiliated Hospital of Shanghai Jiao Tong University from March 2011 to August 2013 were randomly divided into treatment and control groups (n = 51). The patients in the treatment group were given Taxinol Injection on day 1, 175 mg/m² added in 500 mL saline, kept iv drip slowly in 3 h. They were injected with nedaplatin (100 mg/m²) for iv drip on day 2. The patients in the control group were treated with taxinol on day 1, and the usage and dosage were the same as treatment group. They were injected with carboplatin (400 mg/m²) for iv drip on day 2. One course was 28 d, and all patients accepted 1－6 courses of chemotherapy with an average of three courses. Efficacy and side effects of two groups were compared. Results The effective rates in the treatment and control groups were 64.71% and 60.78%, without significant differences. Patients in both groups had side effects such as reduced hemoglobin, neutropenia, and leukopenia, skin rash, hair loss, nausea, vomiting, abnormal liver function and nerve sensation. The incidence of hair loss in two groups was 100%, and the incidence of reduced hemoglobin, neutropenia, and leukopenia, nausea, and vomiting was above 50%. Patients in the treatment group did not have fever and allergies, and the incidence of abnormal nerve sensation was lower than that of the control group with significant difference (P < 0.05). Conclusion There is no difference between paclitaxel combined with nedaplatin or carboplatin in treatment of epithelial ovarian cancer, and the main side effects were bone marrow suppression and gastrointestinal reaction. Clinicians can select the reasonable chemotherapy regimens according to the own clinical tolerance and economic conditions of patients, which helps to reduce the pain of patients and improve their chemotherapy compliance.

國家自然科學(xué)基金資助項目（30973189）