5-氟尿嘧啶联合顺铂、长春新碱治疗妊娠滋养细胞肿瘤的疗效分析  

Analysis of the effect of 5-fluorouracil combined with cisplatin and vincristine in the treatment of gestational trophoblastic neoplasia

作　　者：徐臻[1] 王璐[1] 杨琳俐 王武亮[1] 陈志龙[1] 王倩[1] Xu Zhen;Wang Lu;Yang Linli(Department of Obstetrics and Gynecology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014)

机构地区：[1]郑州大学第二附属医院妇产科,郑州450014

出　　处：《现代妇产科进展》2021年第5期355-359,共5页Progress in Obstetrics and Gynecology

摘　　要：目的:探讨5-氟尿嘧啶(5-FU)微量泵持续泵入联合长春新碱、顺铂(FPV方案)治疗妊娠滋养细胞肿瘤(GTN)的临床疗效。方法:回顾分析2013年10月至2018年10月于郑州大学第二附属医院接受FPV(FPV组)及FAV(FAV组)化疗方案的82例GTN患者的临床资料及治疗结局。结果:82例患者中位随访时间37个月(8~70个月)。FPV组40例患者共接受184疗程化疗,其中2例治疗失败,血清学完全缓解率(SCR)95%。FAV组42例患者共接受190疗程化疗,其中2例治疗失败,SCR 95.2%,差异无统计学意义(P>0.05)。FPV组的1~2级腹泻、3级口腔溃疡的发生率低于FAV组,1~2级恶心呕吐、肝损害、口腔溃疡、3级中性粒细胞减少的发生率高于FAV组,差异有统计学意义(P<0.05),两组4级副反应的发生情况差异无统计学意义(P>0.05)。结论:FPV与FAV方案的疗效相当,主要副反应为胃肠道反应和骨髓毒性,微量泵持续泵入的方法减少5-FU化疗副反应的发生率,提高了患者的耐受性。FPV方案临床效果肯定,有进一步推广的价值。Objective:To explore the clinical efficacy of 5-fluorouracil micropump combined with vincristine and cisplatin(FPV)in the treatment of gestational trophoblastic neoplasia(GTN).Methods:The clinical datas and treatment outcomes of 82 patients with GTN who received FPV or FAV chemotherapy in the Second Affiliated Hospital of Zhengzhou University during October 2013 to October 2018 were analyzed retrospectively.Results:The median follow-up time of 82 patients was 37 months(8~70 months).Forty patients in the FPV group received a total of 184 cycles of chemotherapy,2 of which had a treatment failure,and the serological complete response rate(SCR)was 95%.Forty-two patients in the FAV group received a total of 190 cycles of chemotherapy,of which 2 had a treatment failure,with an SCR of 95.2%.No statistically significant differences in treatment were found between the two groups(P>0.05).FPV group had a lower rate of grade 1~2 diarrhea and grade 3 dental ulcer,while the rate of grade 1~2 nausea and vomiting,liver damage,oral ulcer and grade 3 neutropenia were higher than FAV group(P<0.05).There was no significant differences in the occurrence of grade 4 side-effects between the two groups(P>0.05).Conclusion:The efficacy of FPV is similar to that of FAV.The main side effects are gastrointestinal reaction and bone marrow toxicity.Continuous pumping of micro-pump can reduce the incidence of side effects of 5-fluorouracil chemotherapy and improve the tolerance of patients.The clinical effect of FPV is positive,and it has the value of further promotion.

关 键 词：妊娠滋养细胞肿瘤 化疗 微量泵 5-氟尿嘧啶 

分 类 号：R737.33[医药卫生—肿瘤]