甲氨蝶呤单疗程治疗低危无转移妊娠滋养细胞肿瘤的疗效分析

目的: 观察甲氨蝶呤单疗程治疗低危无转移妊娠滋养细胞肿瘤的疗效。方法: 将105例低危无转移妊娠滋养细胞肿瘤病例按患者自愿原则分为两组，其中60例自愿采用甲氨蝶呤单药单疗程治疗（试验组），45例自愿采用甲氨蝶呤单药多疗程治疗（常规组），比较两组治疗后的完全缓解率、耐药率、复发率、从开始治疗到完全缓解的平均时间、平均疗程数及不良反应发生率。结果： 两组完全缓解率、耐药率、复发率及从开始治疗到完全缓解的平均时间均无明显差异（均P＞0.05）；试验组平均化疗疗程数为（1.90±1.48）次，显著少于常规组的（4.93±2.46）次（P＜0.05）。试验组白细胞减少症（2例，3.33%）、恶心呕吐（6例，10%）及黏膜炎（7例，11.67%）发生率也明显低于常规组分别为13例（28.89%），15例（33.33%）和13例（28.89%），均P＜0.05]。 结论： 甲氨蝶呤单药单疗程化疗疗程短，不良反应发生率低，可作为低危无转移妊娠滋养细胞肿瘤治疗的首选化疗方案。

Analysis of therapeutic efficacy of single-dose methotrexate chemotherapy inlow-risk and non-metastatic gestational trophoblastic tumor

Objective: To analyze the therapeutic efficacy of single-dose regimen of methotrexate(MTX) in the treatment of low-risk non-metastatic gestational trophoblastic tumor(GTT). Methods: A total of 105 patients with low-risk and non-metastatic gestational trophoblastic tumor were enrolled, and were divided into two groups to analyze the efficacy of chemotherapy and the incidence of adverse reaction according to their own will. Sixty patients were voluntarily adopted with single dose of MTX(single-dose group), and the other 45 patients were voluntarily adopted with multi course of MTX(multi-course group). Results: There was no significant difference in complete remission rate,drug resistance rate, recurrence rate and mean time from start to complete remission between the single-dose group and multi-course group.However,the average course of chemotherapy in the single-dose group(1.90±1.48) was significantly less than those in the multi-course group(4.93±2.46, P<0.05).The leucopenia, nausea/vomiting and mucositis rate of the single-dose group was significantly lower than those of multi-course group (3.33% vs 28.89%,10.00% vs 33.33%, 11.67% vs 28.89%, P<0.05). Conclusion: Single-dose MTX chemotherapy has a short course of chemotherapy and a low incidence of side effects, may be an effective option for women with low-risk and non-metastatic gestational trophoblastic tumor. ［Key words］low-risk and non-metastatic gestational trophoblastic tumor; methotrexate; chemotherapy