我院氟化嘧啶类药物治疗妊娠滋养细胞疾病的不良反应回顾性分析

Retrospective Analysis of the Adverse Reactions Caused by Fluoropyrimidine-containing Regime in the Treatment of Gestational Trophoblastic Disease

目的:比较含氟脲苷(FUDR)方案与含5-氟尿嘧啶(5-FU)化疗方案治疗妊娠滋养细胞疾病的不良反应发生率和严重程度。方法:采用回顾性分析方法,统计我院2000年和2005年氟化嘧啶类药物治疗妊娠滋养细胞疾病患者的恶心、呕吐、腹泻等胃肠道反应,及白细胞减少、中性粒细胞减少和血小板减少等骨髓抑制的发生率和严重程度。结果:二联疗法时,初治患者和外院转入患者组,使用含FUDR和含5-FU方案的Ⅲ/Ⅳ度腹泻、白细胞减少、中性粒细胞减少和血小板减少发生率无统计学差异,但初治患者使用含FUDR方案的Ⅲ/Ⅳ度恶心、呕吐发生率显著高于含5-FU方案。三联疗法时,初治患者组,含FUDR方案的Ⅲ/Ⅳ度恶心、呕吐、中性粒细胞减少显著高于含5-FU方案;外院转入组,含FUDR方案的Ⅲ/Ⅳ度白细胞减少、中性粒细胞减少和血小板减少症显著高于含5-FU方案。结论:氟化嘧啶类药物治疗妊娠滋养细胞疾病中,含FUDR三联疗法的严重恶心、呕吐和骨髓抑制发生率高于含5-FU方案。

Objective： To compare the occurrence rate and severity degree of adverse reactions of floxuridine （FUDR）- containing regime and 5-fluorouracil （5-FU）-containing regime in the treatment of patients with gestational trophoblastic disease. Methods： A retrospective analysis was carried out in patients diagnosed as gestational trophoblastic disease in 2000 and 2005, respectively. Their medical charts were reviewed especially those patients treated with fluoropyrimidine-containing regime. The symptoms including nausea or vomiting, diarrhea and myelosuppression were recorded as the adverse reactions and graded for severity according to the NCI-CTC scale. Results： There was no difference on incidences of grade Ⅲ/Ⅳ diarrhea, leucopenia, neutropenia, thrombocytopenia between FUDR-containing two-drug regime and 5-FU-containing two-drug regime. The incidences of grade Ⅲ/Ⅳ nausea or vomiting of FUDR were significantly greater than those in treatment-naive patients after the administration of 5-FU-containing two-drug regime. There was no difference on incidences of grade Ⅲ/Ⅳ diarrhea between FUDR-containing three-drug regime and 5-FU-containing three-drug regime. The incidences of grade Ⅲ/Ⅳ nausea or vomiting, neutropenia of FUDR were significantly greater than those in treatment-naive patients after the administration of 5-FU-containing three-drug regime. The incidences of grade Ⅲ/Ⅳ hematological toxicity of FUDR were significantly higher than those in the patients with 5-FU containing three-drug regime. Conclusion： The incidences of grade Ⅲ/Ⅳ nausea, vomiting and hematological toxicity of FUDR-containing regime were greater than those after the administration of 5-FU-containing three-drug regime.