高危妊娠滋养细胞肿瘤2种方案的疗效比较及耐药相关因素分析  

2 Regimens for the Treatment of High- Risk Gestational Trophoblastic Tumor and Drug Resistance Related Factors

作　　者：朱建平[1] 

机构地区：[1]江苏省大丰市人民医院,江苏盐城224100

出　　处：《中国药业》2015年第23期74-75,共2页China Pharmaceuticals

摘　　要：目的探讨EP方案和5-FU＋KSM方案治疗高危妊娠滋养细胞肿瘤的疗效及耐药相关因素。方法将高危妊娠滋养细胞肿瘤患者76例按不同实施方案分为EP组（40例）和5-FU＋KSM组（36例）。结果两组有效率、恶心呕吐、白细胞下降的发生率比较,差异无统计学意义（P〉0.05）。EP组口腔溃疡、腹泻的发生率、住院时间、化学治疗时间及每日化学治疗时间均显著少于5-FU＋KSM组（P〈0.05）,且前次妊娠为足月产、距上次妊娠时间≥12个月、国际妇产科协会（FIGO）预后总评分≥13分、肿瘤直径≥5 mm的耐药率,均显著高于前次妊娠不足月、距上次妊娠时间〈12个月、FIGO预后总评分为7~12分、肿瘤直径〈5 mm者（P〈0.05）。结论 EP方案用于治疗高危妊娠滋养细胞肿瘤优于5-FU＋KSM方案。且前次妊娠为足月产、距上次妊娠时间≥12个月、FIGO预后总评分≥13分、肿瘤直径≥5 mm均可能是GTN的耐药相关因素。Objective To study the related factors, efficacy and drug resistance of EP and 5- FU ＋ KSM regimen in the treatment of high risk gestational trophoblastic tumor. Methods 76 cases of gestational trophoblastic tumor of high risk pregnancy were divided into40 cases of EP group and 36 cases of 5- FU ＋ KSM group. Results The efficiency, nausea and vomiting, leukopenia occurred in the two groups had no statistically significant difference（ P 〉 0. 05）. The oral ulcers, diarrhea, time of hospitalization, time of chemotherapy and daily time of chemotherapy in the EP group were significantly less than the 5- FU ＋ KSM group（ P 〈 0. 05）. Those whose previous pregnancy to full- term pregnancy, from the last time more than 12 months, the prognosis of FIGO were more than or equal to 13 points,tumor diameter greater than or equal to 5 mm resistance rate were significantly higher than those whose previous pregnancy was less than a month,from the last 12 months of pregnancy,the prognosis total score of FIGO ’total score of 7 to 12,diameter of the tumors’ 5mm（ P 〈 0. 05）. Conclusion The EP regimen used for the treatment of high risk pregnancy trophoblastic tumor is better than that of 5- FU ＋ KSM. And the previous pregnancy to full- term pregnancy,from the last time more than 12 months,the prognosis of FIGO total score more than 13 points,the tumor diameter greater than or equal to 5mm are likely to be associated with drug resistance factors of GTN.

关 键 词：足叶乙苷 顺铂 5-氟尿嘧啶 更生霉素 高危妊娠滋养细胞肿瘤 耐药 

分 类 号：R969.4[医药卫生—药理学] R979.1[医药卫生—药学]