恶性滋养细胞肿瘤治疗、预后的评价-附169例临床分析

The Evaluation of Prognosis and Treatment of Malignant Trophoblastic Neoplasia-Clinical analysis of 169 Cases

目的:对恶性滋养细胞肿瘤按2000年国际妇产科联盟(FIGO)预后评分标准评分并选择治疗方案的疗效进行评价。方法:恶性滋养细胞肿瘤患者169例,治疗前按2000年FIGO预后评分标准进行分期及评分,以此选择治疗方案。结果:169例患者中,绒毛膜癌49例,30例为高危,19例为低危;侵蚀性葡萄胎120例,8例为高危,112例为低危。治疗原则:低危患者以单药化疗为主,高危患者采用多药联合化疗。本组患者的1年、3年、5年生存率分别为98.8%、97.6%及96.9%。无一例因毒副反应或并发症而死亡。结论:治疗前应用2000年FIGO预后评分系统选择恶性滋养细胞肿瘤治疗方案取得较好的临床效果,新分期系统对指导临床治疗有重大意义。

Objective： To evaluate the prognostic score at the 2000 International Federation of Gynecology and Obstetrics（FIGO） standard rated the efficacy of the treatment for malignant trophoblastic neoplasia.Methods： 169 cases of malignant trophoblastic tumor,before treatment,according to the 2000 FIGO prognostic score were determined risk factors,in order to select treatment options.Results： Obstetrics（FIGO） scoring system published in 2000,appropriate treatments were selected for the different patients.Among the 169 cases there were 49 cases of choriocarcinomas and 30 of which were with high-risk factors,the other 19 cases were with low-risk factors;8 of 120 cases of invasive moles which were with high-risk factors and the others were with low-risk factors;The chemotherapy principle was that one agent was used for those patients with low-risk factors and two or multiple-agents were used for those patients with high-risk factors.Among all patients,the one-year,three-year and five-year survival rates were 98.8%,97.6% and 96.9% respectively.No patient died of drug toxicity or complication.Conclusion： Selection of treatment approaches according to the prognostic assessment of malignant trophoblastic neoplasia before treatment could lead to promising survival rate with no uncurable complication and toxic effects.