氟脲苷+更生霉素+依托泊苷+长春新碱作为初始方案治疗妊娠滋养细胞肿瘤的评价

目的 评价氟脲苷＋放线菌素D＋依托泊苷＋长春新碱(FAEV)化疗方案作为妊娠滋养细胞肿瘤(GTN)初始治疗的疗效。方法 回顾性分析了北京协和医院2004年1月至2009年12月间采用FAEV方案初始治疗的38例GTN患者的临床资料,根据国际妇产科联盟(FIGO)预后评分系统(2000年)评分为1～17分(中位数为8分),所有患者均在初始治疗时采用FAEV方案,随诊至2012年12月。结果 38例患者共接受FAEV方案化疗205个疗程,其中,28例(73.6%)血清学完全缓解(SCR),5例(13.2%)出现耐药,5例(13.2%)因不良反应更改为其他化疗方案;剂量限制性不良反应为骨髓抑制,12例(31.6%)发生Ⅲ度及以上中性粒细胞减少。随诊期间,无疾病复发。结论 FAEV方案作为GTN患者的一线治疗方案是有效的,尤其是对于无转移性的低危和高危患者,其有效率达100%且缓解后无复发,并且无严重的不良反应发生。

Combination Chemotherapy Regimen with Floxuridine,Dactinomycin,Etoposide,and Vincristine as Primary Treatment for Gestational Trophoblastic Neoplasia

Objective To evaluate the combination chemotherapy regimen with floxuridine,dactinomycin,etoposide,and vincristine(FAEV)as primary treatment for gestational trophoblastic neoplasia(GTN). Methods Clinical data and outcome of the patients with GTN from 1 January 2004 to 31 December 2009 were retrospectively reviewed. Totally 38 eligible patients had received at least one cycle of FAEV chemotherapy as primary treatment. The primary end points were response rate and toxicity of FAEV regimen. Results Totally 38 patients and 205 cycles of FAEV chemotherapy were included. Twenty-eight of these patients(73.6%)achieved serologic complete remission(SCR). Regimens were changed in 10 patients because of 5 with no response and 5 with intolerable toxicity. The most serious adverse events were greater than or equal to grade 3 neutropenia(31.6%),febrile neutropenia(7.9%),and greater than or equal to grade 3 thrombocytopenia(5.3%). During the follow-up,none relapsed. Conclusion FAEV is an effective regimen with manageable toxicity for patients with GTN as primary treatment,especially for patients with non-metastatic low or high risk GTN.