侵蚀性葡萄胎74例临床资料分析

目的:分析侵蚀性葡萄胎的各种化疗方案及其不良反应。方法:对2006～2011年收治的侵蚀性葡萄胎患者74例进行回顾性分析。结果:患者解剖学分期:Ⅰ期25例,Ⅱ期2例,Ⅲ期47例。根据预后评分分组:低危组(≤6分)67例,高危组(≥7分)7例。MTX单药化疗25例,VMP方案化疗30例,FAVE方案化疗5例,VFA方案化疗2例,化疗过程中出现耐药而更换治疗方案者12例。行全子宫切除术6例。随访时间7～75个月,失访3例,其余随访HCG均在正常范围内。结论:侵蚀性葡萄胎患者以肺转移多见,治疗上以MTX单药、VMP化疗方案为主,耐药者可选择VMP、EMA-CO、FAEV或TP方案,HCG降至正常时无生育要求者及时切除子宫。

Clinical investigation of 74 cases of invasive moles

Objective:To analyze the chemotherapy and its side effects of the invasive mole.Methods:Clinical data of 74 patients with invasive mole from January 2006 to December 2011 were collected and analyzed retrospectively.Results:According to the anatomic stages,25 patients were at stage Ⅰ,2 patients were at stage Ⅱ,47 patients were at stage Ⅲ.Based on the prognostic score grouping,67 patients were in low-risk group(≤6 score);while 7 patients were in high-risk group(>7 score).25 patients were treated with MTX,30 patients were treated with VMP,5 patients were treated with FAVE,2 patients were treated with VFA,12 patients with drug-resistant were replaced with other therapy regimen.6 patients were applied with hysterectomy during the chemotherapy.The follow-up time was from 7 to 75 months,besides 3 patients were not connected,serum HCG value of the rest patients were within the normal range.Conclusion:Lung metastasis is common in patients with invasive mole.MTX and VMP chemotherapy are the main regimen for the treatment of the invasive mole.As for the patients with drug-resistant,VMP,EMA-CO,FAVE,or TP can be chosen for the latter therapy,and the hysterectomy is recommended for the patients without the need of pregnancy after the value of HCG is dropped to normal.