FAEV 方案治疗难治性妊娠滋养细胞肿瘤的疗效分析

目的:研究FAEV方案(氟脲苷+放线菌素D+依托泊苷+长春新碱)治疗难治性妊娠滋养细胞肿瘤(GTN)的疗效及其毒性反应.方法:回顾性分析2005年1月至2008年6月间在北京协和医院接受至少1疗程FAEV化疗的难治性GTN患者的临床资料及治疗结局.结果:共有91例患者纳入研究,其中55例(60.4％)达到血清学完全缓解(SCR),29例(31.9％)对化疗无反应(NR),7例(7.7％)出现了反复的3级以上或难以耐受的化疗副反应.多因素分析表明FAEV方案应用后完全缓解与既往化疗所应用过的方案数目(≤2)明显相关(OR=7.06,95％ CI1.08 ～46.02,P =0.041).最严重的副反应为3度及以上粒细胞减少24例(26.4％)、粒细胞减少性发热6例(6.6％)、3度以上的血小板减少3例(3.3％).结论:FAEV方案对于难治性GTN患者是较为有效的方案,副反应在可控制的范围内,但仍需更进一步的研究.

Efficacy of FAEV Regimen in Treatment of Refractory Gestational Trophoblastic Neoplasia

Objective:To evaluate the efficacy and toxicity of floxuridine, actinomycin D, etoposide,vincristine (FAEV) regimen in the treatment of refractory gestational trophoblastic neoplasia (GTN) ,Methods:From January 2005 to June 2008, 91 cases of refractory GTN were admitted to Peking Union Medical College Hospital and treated with FAEV regimen at least one cycle. The clinical data and outcomes of these patients were retrospectively analyzed. Results:Of91patients, 55cases (60.4% , 55/91) achieved serum complete response (SCR). 29 cases had non-response (NR) to the chemotherapy. 7 cases had Grade 3 or more or intolerable toxicity. Multivariate analysis showed that the efficacy of FAEV was associated with the numbers(≤2) of previous chemotherapy regimens(OR=7.06,95%CI1.08~46.02,P=0.041). The major adverse events of FAEV regimen were Grade ≥3 neutropenia(26.4%), febrile neutropenia (6.6%), and Grade ≥3 thrombocytopenia(3.3%). Conclusions:FEAV is an effective, well-tolerated regimen for patients with the refractory GTN. Further studies of this regimen are warranted.