氟尿嘧啶脱氧核苷单药、联合方案治疗妊娠滋养细胞肿瘤患者的疗效

目的 探讨氟尿嘧啶脱氧核苷(floxuridine,FUDR)单药、联合方案治疗妊娠滋养细胞肿瘤患者的疗效。方法 对1999年4月-2002年12月本院74例妊娠滋养细胞肿瘤患者采用FUDR单药、联合方案化疗,其中侵袭性葡萄胎47例,绒癌27例;Ⅰ期33例,Ⅱ期3例,Ⅲa期3l例,Ⅲb期6例,Ⅳ期l例。2l例系对5-FU或MTX单药、联合方案出现耐药后而改用：FUDR单药、联合方案患者。结果 74例患者中,通过FUDR单药、联合方案获治愈68例(91．9％),其中2l例对5-FU或MTX单药、联合方案耐药而改用FUDR单药、联合方案的患者均获完全缓解,7例Ⅲb期以上的晚期患者亦均获治愈。FUDR单药、联合方案的主要副反应为骨髓抑制和胃肠道反应,其中Ⅲ一Ⅳ度粒细胞减少占26％,Ⅲ-Ⅳ度血小板减少占6．2％,Ⅲ度恶心呕吐占57．1％,Ⅲ度腹泻占4．3％。结论 FUDR单药、联合方案治疗妊娠滋养细胞肿瘤可达满意的临床效果,对其他药物耐药或晚期病例也可获得满意的疗效。

Floxuridine-containing regime in the treatment of gestational trophoblastic tumor

OBJECTIVE: To analyse the efficacy of the floxuridine (FUDR)-containing regime (single agent or in combination) in the treatment of gestational trophoblastic tumor. METHODS: Seventy-four patients with gestational trophoblastic tumors (GTT), 47 invasive mole and 27 choriocarcinoma, were treated with FUDR-containing regime. The clinical staging of the disease were: 33 cases of stage I, 3 cases of stage II, 31 cases of stage IIIa, 6 cases of stage IIIb, and 1 case of stage IV. RESULTS: The cure rate of FUDR-containing regime in the treatment of GTT was 91.9% (68 out of 74 cases). Twenty-one out of these 74 patients showed drug resistant to 5-FU-containing or MTX-containing regime and were cured after they changed to the FUDR-containing regime. All 7 patients of advanced stage (> or = III b) got cured. The major adverse event of FUDR-containing regime was myelodepression and gastrointestinal toxicity: III-IV degree granulopenia 26%, III-IV thrombopenia 6.2%, III degree vomiting 57.1%, and III degree diarrhea 4.3%. CONCLUSION: FUDR-containing regime is efficient for the treatment of GTT, even for those with advanced stage or drug-resistant disease.