Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2016, Vol. 12 ›› Issue (06): 644 -650. doi: 10.3877/cma.j.issn.1673-5250.2016.06.005

Special Issue:

Original Article

Concurrent chemoradiatherapy with raltitrexed and cisplatin in the treatment of moderate and advanced cervical cancer

Xiaomei Xie1, Xiangyang Li1,(), Haitao Yin1, Yifan Zhang1, Ling Liu1, Xiangzhao Bu1, Lingfei Sun1, Luan Guan1   

  1. 1. Department of Radiation Oncology, Xuzhou Central Hospital, Affiliated to School of Medicine, Southeast University, Xuzhou 221009, Jiangsu Province, China
  • Received:2016-05-07 Revised:2016-11-09 Published:2016-12-01
  • Corresponding author: Xiangyang Li
  • About author:
    Corresponding author: Li Xiangyang, Email:
Objective

To investigate the efficacy and safety of concurrent chemoradiatherapy with raltitrexed and cisplatin in treatment of patients with moderate and advanced cervical cancer.

Methods

From January 2011 to December 2012, a total of 80 patients with moderate and advanced cervical cancer were selected as research subjects and they were randomly assigned to RP group (n=40, received concurrent chemoradiatherapy with raltitrexed and cisplatin treatment) and TP group (n=40, received concurrent chemoradiatherapy with paclitaxel and cisplatin treatment) by envelope method. The chemotherapy regimen of RP group was as follows: raltitrexed 3 mg/m2 intravenous drip 15 min on day 1, and cisplatin 60 mg/m2 intravenous drip 60 min on day 1. The chemotherapy regimen of TP group was as follows: paclitaxel 135 mg/m2 intravenous drip 180 min on day 1, and cisplatin 60 mg/m2 intravenous drip 60 min on day 2. The effective rate, adverse reactions rate, and overall survival (OS) rate and disease free survival (DFS) rate were observed and compared by statistical methods between two groups. This study was approved by the ethics committee of our hospital, and all patients signed the informed consent.

Results

①There were no significant differences between two groups in the age, Karnofsky performance status (KPS) score, body weight loss ratio, the maximum diameter of tumor, pathological type, Federation International of Gynecology and Obstetrics (FIGO) stage (P>0.05). ②The effective rates in RP group and TP group were 92.5% (38/40) and 90% (36/40), respectively, and there was no significant difference between them (χ2=0.734, P=0.675). ③The incidences of myelosuppression, rash, alopecia, muscle and joint pain, peripheral neuritis in RP group were 62.5% (25/40), 12.5% (5/40), 30.0% (12/40), 5.0% (2/40), 10.0% (4/40), respectively, and they were significantly lower than those in TP group 82.5% (33/40), 35.0% (14/40), 80.0% (32/40), 25.0% (10/40), 32.5% (13/40), respectively, and all the differences were statistically significant (χ2=4.013, P=0.045; χ2=5.591, P=0.018; χ2=20.202, P<0.001; χ2=6.275, P=0.012; χ2=6.050, P=0.014). There were no significant differences between two groups in gastrointestinal toxicity and liver dysfunction (P>0.05). ④There were no significant differences between two groups in OS curve and DFS curve (χ2=0.930, P=0.330; χ2=0.780, P=0.380).

Conclusions

Concurrent chemoradiatherapy with raltitrexed and cisplatin in the treatment of moderate and advanced cervical cancer is safe and effective. Its effect is similar to the effect of concurrent chemoradiatherapy with paclitaxel and cisplatin, and resulting in less adverse reactions.

表1 2组宫颈癌患者基本临床资料比较
表2 2组宫颈癌患者不良反应发生情况比较[例数(%)]
组别 例数 恶心 呕吐
1级 2级 3级 4级 5级 合计 1级 2级 3级 4级 5级 合计
RP组 40 9(22.5) 23(57.5) 7(17.5) 1(2.5) 0(0) 31(77.5) 25(62.5) 9(22.5) 6(15.0) 1(2.5) 0(0) 15(37.5)
TP组 40 8(20.0) 24(60.0) 7(17.5) 1(2.5) 0(0) 32(80.0) 23(57.5) 9(22.5) 7(17.5) 1(2.5) 0(0) 17(42.5)
χ2 ? 0.075 0.208
P ? 0.785 0.648
组别 例数 腹泻 食欲下降
1级 2级 3级 4级 5级 合计 1级 2级 3级 4级 5级 合计
RP组 40 25(62.5) 9(22.5) 5(12.5) 1(2.5) 0(0) 15(37.5) 17(42.5) 16(40.0) 7(17.5) 0(0) 0(0) 23(57.5)
TP组 40 28(70.0) 8(20.0) 4(10.0) 0(0) 0(0) 12(30.0) 16(40.0) 17(42.5) 7(17.5) 1(2.5) 0(0) 24(60.0)
χ2 ? 0.503 0.052
P ? 0.478 0.82
组别 例数 骨髓抑制 肝功能损害
1级 2级 3级 4级 5级 合计 1级 2级 3级 4级 5级 合计
RP组 40 15(37.5) 13(32.5) 11(27.5) 4(10.0) 0(0) 25(62.5) 35(87.5) 5(12.5) 1(2.5) 0(0) 0(0) 5(12.5)
TP组 40 7(17.5) 13(32.5) 12(30.0) 7(17.5) 1(2.5) 33(82.5) 34(85.0) 6(15.0) 1(2.5) 0(0) 0(0) 6(15.0)
χ2 ? 4.013 0.105
P ? 0.045 0.745
组别 例数 皮疹 脱发
1级 2级 3级 4级 5级 合计 1级 2级 3级 4级 5级 合计
RP组 40 35(87.5) 4(10.0) 1(2.5) 0(0) 0(0) 5(12.5) 28(70.0) 12(30.0) 0(0) 0(0) 0(0) 12(30.0)
TP组 40 26(65.0) 8(20.0) 4(10.0) 2(5.0) 0(0) 14(35.0) 8(20.0) 15(37.5) 17(42.5) 0(0) 0(0) 32(80.0)
χ2 ? 5.591 20.202
P ? 0.018 0.000
组别 例数 肌肉和关节疼痛 外周神经炎
1级 2级 3级 4级 5级 合计 1级 2级 3级 4级 5级 合计
RP组 40 38(95.0) 1(2.5) 1(2.5) 0(0) 0(0) 2(5.0) 36(90.0) 2(5.0) 2(5.0) 0(0) 0(0) 4(10.0)
TP组 40 30(75.0) 6(15.0) 4(10.0) 0(0) 0(0) 10(25.0) 27(67.5) 6(15.0) 5(12.5) 2(5.0) 0(0) 13(32.5)
χ2 ? 6.275 6.050
P ? 0.012 0.014
图1 2组宫颈癌患者总生存曲线比较
图2 2组宫颈癌患者无病生存曲线比较
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Abstract