MAC与EMA-CO方案治疗妊娠滋养细胞肿瘤肺转移的疗效对比分析  

Clinical research gestational trophoblastic tumor lung metastases

作　　者：陈娅莉[1] 徐亿力[1] 

机构地区：[1]武汉市第一医院产科,湖北武汉430030

出　　处：《现代肿瘤医学》2016年第2期291-294,共4页Journal of Modern Oncology

基　　金：武汉市卫生局临床重点专科科研项目(编号:10C01)

摘　　要：目的:对比评价两方案(MAC方案与EMA-CO方案)治疗妊娠滋养细胞肿瘤肺转移的疗效和毒副反应,以期为妊娠滋养细胞肿瘤肺转移化疗提供借鉴。方法:选择2009年6月至2013年12月的妊娠滋养细胞肿瘤肺转移患者124例作为研究对象,采用随机数字表法将其随机分为两组:治疗组和对照组,对照组予以EMA-CO方案治疗,治疗组MAC方案治疗,观察其疗效和副反应评价。结果:MAC方案组与EMA-CO方案组治疗妊娠滋养细胞肿瘤肺转移的完全缓解率分别为76.67%和71.88%,有效率分别为96.67%和100%;完全缓解率及有效率的比较经χ2检验,P>0.05,差异无显著性意义,MAC方案低危型CR率明显高于EMA-CO方案,高危型CR率低于EMA-CO方案,组间比较差异均有统计学意义;MAC方案组血HCG降至正常时间及总疗程均较EMA-CO方案组少。两组患者恶心呕吐发生率、肝肾损伤发生率比较,P>0.05,在统计学上无明显差异;但MAC组的骨髓抑制发生率和肝肾损伤发生率、严重程度及腹泻发生率、口腔溃疡发生率均低于EMA-CO组,P均<0.05,差异有统计学意义。另外,MAC方案组的复发率、平均住院日、化疗时间、费用等指标均较EMA-CO方案组少。结论:采用MAC方案治疗妊娠滋养细胞肿瘤肺转移的总体疗效与EMA-CO方案相当,MAC组重度骨髓抑制、胃肠道反应及口腔溃疡的发生明显少于EMA-CO组,并且疗程短,化疗时间及费用少,复发率低,患者更易于接受,依从性好,可以作为临床一线用药进一步推广。Objective： comparative two treatments of gestational trophoblastic efficacy and toxicity with tumor lung metastases. Methods： All 124 patients with lung metastases were randomly divided into two groups,the treatment group and the control group. The control group was given EMA- CO regimen,the treatment group MAC regimen. Results： MAC program group and EMA- CO regimen treatment of gestational trophoblastic tumor complete response rate of pulmonary metastasis were 76. 67% and 71. 88%,effective rate was 96. 67% and 100%,respectively. P〈0. 05,the difference was not statistically significant in two groups. FIGO prognostic score low risk and high- risk CR rate and CR ＋ PR rate differences were statistically significant,MAC scheme CR rate was significantly low risk higher than EMA- CO program,high- risk CR rate lower than EMA- CO program,there were significant differences between the groups. Two groups of patients the incidence of nausea and vomiting,the incidence of liver and kidney damage,P〉0. 05,no statistically significant difference. MAC croup marrow suppression and kidney injury incidence rate and severity,the incidence of diarrhea,mouth ulcers were lower than EMA- CO group,P〈0. 05. Conclusion： MAC regimen gestational trophoblastic tumor lung metastases overall efficacy and EMA- CO program fairly,MAC group and severe bone marrow suppression,gastrointestinal reactions and oral ulcers was significantly less than the EMA- CO group,and short course chemotherapy time and cost less,recurrence rate.

关 键 词：妊娠滋养细胞肿瘤肺转移 MAC方案 EMA-CO方案 

分 类 号：R737.33[医药卫生—肿瘤]