FAEV方案治疗难治性妊娠滋养细胞肿瘤的疗效分析  

Efficacy of FAEV Regimen in Treatment of Refractory Gestational Trophoblastic Neoplasia

作　　者：任彤[1] 冯凤芝[1] 向阳[1] 万希润[1] 王涛[1] 杨秀玉[1] 

机构地区：[1]中国医学科学院北京协和医院,北京100730

出　　处：《实用妇产科杂志》2012年第7期555-559,共5页Journal of Practical Obstetrics and Gynecology

基　　金：国家科技支撑计划课题基金(编号:2008BAI57B05)

摘　　要：目的:研究FAEV方案(氟脲苷+放线菌素D+依托泊苷+长春新碱)治疗难治性妊娠滋养细胞肿瘤(GTN)的疗效及其毒性反应。方法:回顾性分析2005年1月至2008年6月间在北京协和医院接受至少1疗程FAEV化疗的难治性GTN患者的临床资料及治疗结局。结果:共有91例患者纳入研究,其中55例(60.4%)达到血清学完全缓解(SCR),29例(31.9%)对化疗无反应(NR),7例(7.7%)出现了反复的3级以上或难以耐受的化疗副反应。多因素分析表明FAEV方案应用后完全缓解与既往化疗所应用过的方案数目(≤2)明显相关(OR=7.06,95%CI1.08～46.02,P=0.041)。最严重的副反应为3度及以上粒细胞减少24例(26.4%)、粒细胞减少性发热6例(6.6%)、3度以上的血小板减少3例(3.3%)。结论:FAEV方案对于难治性GTN患者是较为有效的方案,副反应在可控制的范围内,但仍需更进一步的研究。Objective：To evaluate the efficacy and toxicity of floxuridine, actinomycin D, etoposide,vin- cristine （FAEV） regimen in the treatment of refractory gestational trophoblastic neoplasia （GTN） , Methods： From January 2005 to June 2008, 91 cases of refractory GTN were admitted to Peking Union Medical Col- lege Hospital and treated with FAEV regimen at least one cycle. The clinical data and outcomes of these pa- tients were retrospectively analyzed. Results： Of 91 patients, 55 cases （60.4% , 55/91） achieved serum complete response （SCR）. 29 cases had non-response （NR） to the chemotherapy. 7 cases had Grade 3 or more or intolerable toxicity. Multivariate analysis showed that the efficacy of FAEV was associated with the numbers（≤2） of previous chemotherapy regimens（ OR =7. 06,95%CI1.08 -46.02, P =0. 041 ）. The major adverse events of FAEV regimen were Grade ≥3 neutropenia（26.4%）, febrile neutropenia （6.6%）, and Grade ≥3 thrombocytopenia（3.3%）. Conclusions： FEAV is an effective, well-tolerated regimen for pa- tients with the refractory GTN. Further studies of this regimen are warranted.

关 键 词：化疗 FAEV方案 妊娠滋养细胞肿瘤 补救化疗 

分 类 号：R737.33[医药卫生—肿瘤]