白蛋白结合型紫杉醇在宫颈癌新辅助化疗中的研究进展

doi:10.12280/gjfckx.20200802

摘要/Abstract

摘要：

宫颈癌发病率位居全球女性恶性肿瘤第4位,是发展中国家女性恶性肿瘤死亡的主要原因。部分经济、文化相对落后的地区对“宫颈癌阶梯筛查”的知晓度及实施率较差,超过1/3的患者发现患宫颈癌时即为国际妇产科联盟（FIGO）ⅠB3期及以上（2018年FIGO分期）,失去最佳手术时机。术前利用新辅助化疗以缩小肿瘤、消灭微小转移灶这一治疗理念在多个瘤种中得到公认,在国内宫颈癌治疗中也得到了大量实践,但宫颈癌新辅助化疗具体方案尚未统一。紫杉醇是宫颈癌化疗常用药物,其毒性较高,患者耐受性差,白蛋白结合型紫杉醇以人血清白蛋白为溶剂制成小分子纳米颗粒,低毒、高效,作为新型紫杉醇制剂被广泛应用。现对白蛋白结合型紫杉醇及传统溶剂型紫杉醇的原理、在宫颈癌新辅助化疗中的疗效、不良反应及其远期应用进行综述。

关键词: 宫颈肿瘤, 癌, 白蛋白结合型紫杉醇, 化学疗法, 辅助, 药物相关性副作用和不良反应, 新辅助化疗

Abstract:

The incidence of cervical cancer ranks fourth in the world for female malignancies, and it is the main cause of cancer deaths among women in developing countries. In some areas where the economy and culture are relatively backward, the awareness and implementation rate of "step screening for cervical cancer" are poor, so that more than 1/3 patients are at stage ⅠB3 (FIGO stage in 2018) and above of the cervical cancer when they found it, and lost the best time for operation. The concept of neoadjuvant chemotherapy (NACT) before operation, which is in order to shrink tumors and eliminate micrometastases, has been widely accepted in many tumor species. It also has been practiced a lot in the treatment of cervical cancer in China. However, the concrete proposal of NACT for cervical cancer has not been unified yet. Paclitaxel is a commonly used drug in the chemotherapy of cervical cancer, which is highly toxic and poorly tolerated by patients. The nanoparticle albumin bound paclitaxel (Nab-paclitaxel), a small molecule nanoparticle which uses human serum albumin as the solvent, is poorly toxicity and highly efficiency. As a new formulation of paclitaxel, it is widely used. Now, this article summarizes the principles, the efficacy, adverse reactions and long-term application of Nab-paclitaxel and traditional solvent-based paclitaxel in NACT for cervical cancer.

Key words: Uterine cervical neoplasms, Carcinoma, Albumin-bound paclitaxel, Chemotherapy, adjuvant, Drug-related side effects and adverse reactions, Neoadjuvant chemotherapy

候丽盈, 刘艳, 鲁鹏, 孙树, 李佩玲. 白蛋白结合型紫杉醇在宫颈癌新辅助化疗中的研究进展[J]. 国际妇产科学杂志, 2021, 48(2): 135-138.

HOU Li-ying, LIU Yan, LU Peng, SUN Shu, LI Pei-ling. Research Progress of Nanoparticle Albumin Bound Paclitaxel in Neoadjuvant Chemotherapy for Cervical Cancer[J]. Journal of International Obstetrics and Gynecology, 2021, 48(2): 135-138.

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不良反应	Nab-paclitaxel		溶剂型紫杉醇
不良反应	不良反应分级	不良反应发生率（%）	不良反应分级	不良反应发生率（%）
白细胞减少	0~4	71.4	0~4	70
	3	8.6	3~4	46
中性粒细胞减少	0~4	42.9	0~4	42
	3~4	8.6	3~4	40
贫血	0~4	91.4	0~4	24
	3	11.4	3~4	8
脱发	0~2	51.4	0~2	44
恶心/呕吐	0~2	57.1	0~3	26
神经毒性	0~3	57.1	0~4	6

不良反应	Nab-paclitaxel		溶剂型紫杉醇
不良反应	不良反应分级	不良反应发生率（%）	不良反应分级	不良反应发生率（%）
白细胞减少	0~4	71.4	0~4	70
	3	8.6	3~4	46
中性粒细胞减少	0~4	42.9	0~4	42
	3~4	8.6	3~4	40
贫血	0~4	91.4	0~4	24
	3	11.4	3~4	8
脱发	0~2	51.4	0~2	44
恶心/呕吐	0~2	57.1	0~3	26
神经毒性	0~3	57.1	0~4	6