目的 研究吉西他滨联合奈达铂治疗复发性宫颈癌的疗效和安全性。方法 将2012年2月-2014年1月上海交通大学附属第六人民医院收治的98例宫颈癌复发患者作为研究对象，通过随机抽样分为治疗组和对照组，每组各49例。治疗组静脉滴注注射用吉西他滨1 g/m²加入0.9%生理盐水100 mL，持续30 min，每个化疗周期前3周的第1天使用；注射用奈达铂80 mg/m²用0.9%生理盐水稀释至500 mL后静脉滴注，滴注时间至少为60 min，每个周期的第1周第1天时使用。对照组吉西他滨使用方法与治疗组一致；注射用顺铂30 mg/m²注入0.9%生理盐水30 mL后静脉滴注，每个周期的第1周前3 d时每天使用。两组都以28 d为1个疗程，并至少治疗2个疗程。治疗结束后，比较两组的临床疗效和毒副作用情况。结果 治疗组和对照组治疗有效率分别为63.27%、55.10%，两组比较差异无统计学意义。在毒副作用方上，两组脱发、白细胞下降、心脏毒性、肺毒性、肝损害以及皮疹的发生率差异无统计学意义。治疗组血小板降低发生率高于对照组，但在恶心呕吐、血红蛋白下降和肾脏损害的发生率均明显低于对照组，两组比较差异有统计学意义（P<0.05）。结论 吉西他滨联合奈达铂或顺铂治疗复发性宫颈癌的临床疗效无差异，但吉西他滨联合奈达铂的毒副反应较小，有利于减少患者化疗痛苦，提高患者依从性。

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.

国家自然科学基金资助项目（30973189）