妊娠滋养细胞肿瘤251例临床分析

目的:探讨妊娠滋养细胞肿瘤(GTT)的治疗方法及疗效。方法:对251例GTT患者应用CMV方案(卡铂、氨甲蝶呤、长春新碱)及"双枪方案"(5-氟尿嘧啶、更生霉素)两种化疗方案的治疗效果及联合手术治疗的疗效结果进行回顾性分析。结果:251例GTT患者,完全缓解率88.05%。其中,CMV方案完全缓解率87.78%(79/90),"双枪方案"完全缓解率83.82%(57/68),两组间完全缓解率无显著性差异(P>0.05),两组间耐药性的产生有显著性差异(P<0.05),化疗副反应中,口腔溃疡、腹泻发生率有显著性差异(P<0.05)。单纯化疗完全缓解率86.08%(136/158),化疗联合手术治疗完全缓解率91.40%(85/93)。结论:CMV化疗方案,效果肯定,不易产生耐药性,且化疗副反应轻,临床较易执行,可作为一种治疗选择。对于具有手术指征的患者化疗后联合手术治疗,疗效更好。

Clinical analysis of 251 cases of gestational trophoblastic tumor

Objective:To discuss the treatment methods and curative effect of gestational trophoblastic tumor(GTT).Methods:251 GTT patients were treated with CMV programme(carboplatin,methotrexate,vincristine) and "double gun scheme"(5-fluoride and dactinomycin),effect of two kinds of chemotherapy treatment and therapeutic effect of combined surgery were retrospectively analyzed.Results:The complete remission rates were 88.05% in all patients,87.78%(79/90) in patients receiving CMV programme only,and 83.82%(57/68) in patients receiving double gun scheme only.There was no significant complete remission rate difference between the two groups(P>0.05).There was significant difference in drug resistance between the two groups(P<0.05).There were significant differences between the two groups in oral ulcers and diarrhea in the chemotherapy side effects(P<0.05).The pure chemotherapy complete remission rate was 86.08%(136/158),and chemotherapy and surgery treatment complete remission rate was 91.4%(85/93).Conclusion:The effect of CMV programm is sure,difficult to produce antimicrobial resistance,with minor chemotherapy side effects,clinical easier to implement,and can be used as a kind of treatment options.Indications for surgery after chemotherapy in patients with combined surgery,the curative effect is better.