长春新碱放线菌D依托泊苷氟脲苷治疗高危型妊娠滋养细胞肿瘤的疗效观察  

Clinical efficacy of FAEV regimen in the treatment of high risk gestational trophoblast tumor

作　　者：施琰红 

机构地区：[1]北京和美妇儿医院,北京100029

出　　处：《中国肿瘤临床与康复》2016年第5期559-562,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨长春新碱+放线菌D+依托泊苷+氟脲苷(FAEV)方案治疗高危型妊娠滋养细胞肿瘤(GTN)的临床疗效。方法选取2011年1月至2012年12月间接受初次化疗的38例高危型GTN患者,按照随机数字表法分为实验组和对照组,每组19例。实验组患者接受FAEV方案化疗,对照组患者接受氟尿嘧啶+更生霉素(5-Fu+KSM)方案化疗,观察比较两组患者的临床疗效、疗程及不良反应。结果实验组患者血清学意义上的完全缓解(s CR)率、耐药(NR)和复发(REC)发生率分别为78.9%、21.1%和0.0%,对照组则分别为57.9%、26.3%和5.3%,差异均有统计学意义(P<0.05)。实验组患者中,3例NR改行放线菌素D+甲氨蝶呤+环磷酰胺+长春新碱+VP16(EMA-CO)方案化疗后获得s CR。对照组患者中,6例NR患者改行EMA-CO方案化疗后获得s CR。对照组患者中,2例REC患者先行手术切除治疗后,再行EMA-CO方案化疗后获得s CR。实验组患者绒毛膜促性腺激素β-亚基(β-h CG)下降至≤2 U/L疗程、巩固化疗疗程数及总疗程数与对照组间差异无统计学意义(P>0.05)。实验组的口腔溃疡、腹泻发生率分别为5.3%和10.5%,对照组则分别为84.2%和68.4%,差异有统计学意义(P<0.05)。结论 FAEV化疗方案治疗高危型CTN疗效显著,不良反应发生率低。Objective To study the clinical efficacy of FAEV scheme（ vincristine ＋ actinomycetes D ＋ etoposide ＋ FUDR） in the treatment of high risk gestational trophoblastic tumor（ GTN）. Methods From January 2011 to December 2012 in Beijing Hemei Women and Children Hospital,38 high-risk GTN patients with initial chemotherapy were enrolled in the study. And they were randomly divided into the experimental group and the control group,19 cases in each group. The patients in the experimental group accepted FAVE regimen and those in the control group accepted 5-Fluorouracil（ 5-FU） ＋ kengsengmycin（ KSM） chemotherapy. The clinical efficacy and side effects between the two groups were compared.Results The serum complete response（ s CR）,resistance（ NR）,recurrence（ REC） incidence of the experimental group were 78. 9%,21. 1%,0. 0% respectively,and those in the control group 57. 9%,26. 3%,5. 3%,with significant differences（ P〈0. 05）. In the experimental group,3 NR cases diverted EMA-CO [actinomycetes（ D ＋ methotrexate and cyclophosphamide,vincristine ＋ VP16） scheme of chemotherapy after obtaining s CR,and in the control group 6 NR patients were switched to EMA-CO regimen chemotherapy after obtaining s CR. In the control group,2 patients with REC were treated by EMA-CO,and then received s CR after chemotherapy. In the experimental group,serum β-subunit of human choionic gonadotophin（ β-h CG） dropped to less than or equal to 2 U/L course of treatment consolidate course of chemotherapy and total course of treatment and the control group had no significant difference（ P〉0. 05）. The oral ulcers,diarrhea incidence of the experimental group were 5. 3%,10. 5%,and the control group84. 2%,68. 4%,with significant differences（ P〈0. 05）. Conclusion FAVE regimen in the treatment of patients with high-risk CTN has obvious curative effect,and adverse reaction rate is low. It has certain advantages in the treatment of high risk CTN.

关 键 词：妊娠滋养细胞疾病 药物疗法 安全计生 治疗结果 

分 类 号：R737.33[医药卫生—肿瘤]