BEP方案治疗高危型妊娠滋养细胞肿瘤的疗效及安全性评价

Evaluation of Efficacy and Safety of BEP Regimen in the Treatment of High-risk Gestational Trophoblastic Tumor

目的:探讨高危型妊娠滋养细胞肿瘤采用BEP方案治疗的临床效果及安全性。方法:本次研究选择的对象共40例,均为本院2005年2月-2012年9月收治的高危型妊娠滋养细胞肿瘤的患者,给予博来霉素+依托泊苷+顺铂(BEP)方案救治,并回顾分析其临床资料。结果:本组40例患者,平均接受BEP方案化疗(6.1±0.2)个疗程,其中完全缓解36例,占90%;耐药者4例,占10%。耐药患者平均进行(4.7±0.1)个疗程时出现耐药,均改用环磷酰胺+长春新碱(CO)/依托泊苷+甲氨蝶呤+放红菌素D(EMA)方案化疗,辅以手术治疗1例,辅以放疗治疗2例,后死亡1例,完全缓解3例。主要不良反应以脱发、消化道不适、骨髓抑制为主,其次为肝功能损害、外周神经炎,脱发与其他的不良反应比较差异有统计学意义(P<0.05)。结论:高危型妊娠滋养细胞肿瘤采用BEP方案治疗临床效果显著,且使患者医疗安全获得保障,具有非常重要的应用价值。

Objective：To explore the clinical efficacy and safety of BEP regimen in the treatment of high-risk gestational trophoblastic tumor. Method：40 cases of patients with high-risk gestational trophoblastic tumor were treated with bleomycin＋etoposide＋cisplatin（BEP）from February 2005 to September 2012.Result：The course of treatment was（6.1±0.2）chemotherapy cycle.36 cases of patients achieved complete remission,accounted for 90%.4 cases of patients had drug resistance,accounted for 10%.The average time of drug resistance occured in（4.7±0.1）chemotherapy cycle,and then treated with cyclophosphamide＋ vincristine（CO）/etoposide＋methotrexate＋put red of actinomycin D（EMA）.On basis of chemotherapy,1 case of patients was treated with operation,2 cases of patients were treated with radiotherapy,and 1 case died,3 cases of patients achieved complete remission. The main adverse reaction included hair loss,gastrointestinal discomfort and bone marrow suppression,secondary adverse reaction included liver function damage and peripheral neuritis,the differences were statistically significant（ P 0.05）.Conclusion：BEP regimen have good clinical efficacy and safety in the treatment of high-risk gestational trophoblastic tumor,and has very important application value.