目的 研究吉西他濱聯(lián)合奈達(dá)鉑治療復(fù)發(fā)性宮頸癌的療效和安全性。方法 將2012年2月-2014年1月上海交通大學(xué)附屬第六人民醫(yī)院收治的98例宮頸癌復(fù)發(fā)患者作為研究對(duì)象，通過隨機(jī)抽樣分為治療組和對(duì)照組，每組各49例。治療組靜脈滴注注射用吉西他濱1 g/m²加入0.9%生理鹽水100 mL，持續(xù)30 min，每個(gè)化療周期前3周的第1天使用；注射用奈達(dá)鉑80 mg/m²用0.9%生理鹽水稀釋至500 mL后靜脈滴注，滴注時(shí)間至少為60 min，每個(gè)周期的第1周第1天時(shí)使用。對(duì)照組吉西他濱使用方法與治療組一致；注射用順鉑30 mg/m²注入0.9%生理鹽水30 mL后靜脈滴注，每個(gè)周期的第1周前3 d時(shí)每天使用。兩組都以28 d為1個(gè)療程，并至少治療2個(gè)療程。治療結(jié)束后，比較兩組的臨床療效和毒副作用情況。結(jié)果 治療組和對(duì)照組治療有效率分別為63.27%、55.10%，兩組比較差異無統(tǒng)計(jì)學(xué)意義。在毒副作用方上，兩組脫發(fā)、白細(xì)胞下降、心臟毒性、肺毒性、肝損害以及皮疹的發(fā)生率差異無統(tǒng)計(jì)學(xué)意義。治療組血小板降低發(fā)生率高于對(duì)照組，但在惡心嘔吐、血紅蛋白下降和腎臟損害的發(fā)生率均明顯低于對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 吉西他濱聯(lián)合奈達(dá)鉑或順鉑治療復(fù)發(fā)性宮頸癌的臨床療效無差異，但吉西他濱聯(lián)合奈達(dá)鉑的毒副反應(yīng)較小，有利于減少患者化療痛苦，提高患者依從性。

Objective To explore the efficacy and safety of Gemcitabine combined with Nedaplatin in the treatment of recurrent cervical cancer Methods Recurrent cervical cancer patients (98 cases) who came to the Sixth Affiliated People's Hospital of Shanghai Jiao Tong University from February 2012 to January 2014 were randomly divided into treatment and control groups (n = 49) by the method of simple random sampling. The patients in the treatment group were given Gemcitabine for iv injection (1 g/m²) by adding in 0.9% normal saline (100 mL), slowly dripping for 30 min, and used on day 1 of the fore three weeks in each chemotherapy cycle. They were injected with Nedaplatin for iv injection (80 mg/m²) by adding in 0.9% normal saline (500 mL), slowly dripping for 60 min, and used on day 1 of the first week in each chemotherapy cycle. The patients in the control group were treated with Gemcitabine for iv injection, and the usage and dosage were the same as those in the treatment group. They were iv injected with Cisplatin for (30 mg/m²) by adding in 0.9% normal saline (30 mL) used on fore 3 d of the first week in each chemotherapy cycle. One course was 28 d in both groups and all the patients accepted the treatment for 2 courses at least. Efficacy and side effects of the two groups were compared after the treatment. Results The effective rates in the treatment and control groups were 63.27% and 55.10%,without significant differences. On adverse reactions, there were no significant differences between the two groups in hair loss, reduced leukopenia, cardiac toxicity, pulmonary toxicity, liver damage, and skin rash. The incidence of reduced platelets in the treatment group was higher than that in the control group, but incidence of nausea, vomiting, reduced hemoglobin, and kidney damage was significantly lower than those in the control group with significant difference (P < 0.05). Conclusion There is no difference between Gemcitabine combined with Nedaplatin or Cisplatin in the treatment of recurrent cervical cancer, but the main side effects are small, which could help the patients reduce the pain and improve the chemotherapy compliance.

國家自然科學(xué)基金資助項(xiàng)目（30973189）