氟尿嘧啶脱氧核苷与5-氟尿嘧啶治疗妊娠滋养细胞肿瘤的疗效比较

Contrast of efficacy between floxuridine and 5-fluorouracil for gestational trophoblastic tumor

目的 观察氟尿嘧啶脱氧核苷（FUDR）与5-氟尿嘧啶（5-Fu）治疗妊娠滋养细胞肿瘤（GTT）患者的疗效和不良反应。方法 回顾性分析111例Ⅱ～Ⅲ期低评分GTT患者的资料，患者包括侵蚀性葡萄胎62例和绒毛膜癌49例，分为FUDR＋更生霉素（KSM）组55例和5-Fu＋KSM组56例。FUDR每天23 mg／kg静脉缓慢滴注，维持8 h；KSM每天6 μg／kg静脉缓慢滴注，维持4 h；5-Fu每天26 mg／kg静脉缓慢滴注，维持8 h。两方案均连用8 d。结果 FUDR＋KSM组治愈率98 %（54／55），5-Fu＋KSM组治愈率96 %（54／56）。FUDR＋KSM组局部静脉炎、口腔溃疡、脱发的发生率低于5-Fu＋KSM组[29.1 %（16／55）比85.7 %（48／56），54.5 %（30／55）比98.2 %（55／56），21.8 %（12／55）比89.3 %（50／56），均P＜0.05]。Ⅲ期的FUDR＋KSM组患者和Ⅲ期5-Fu＋KSM组患者比较，脱发、口腔溃疡、局部静脉炎的不良反应发生率差异均有统计学意义（均P＜0.05）。结论 FUDR在用药量减少的基础上，治疗GTT的疗效与5-Fu相同，而口腔溃疡、脱发、局部静脉炎的发生率更低，骨髓抑制及腹泻的发生情况与5-Fu相似。

Objective To compare the efficacy and adverse reactions between floxuridine （FUDR） and 5-fluorouracil （5-Fu） treatment of gestational trophoblastic tumor. Methods 111 trophoblastic tumor patients of Ⅱ-Ⅲstage including 62 cases of in vasive mole and 49 cases of choriocarcinoma were analyzed retrospectinely. The patients were divided into FUDR＋KSM group （55 cases） and 5-Fu＋KSM group （56 cases）. FUDR was according to 23 mg/kg？d phleb instillation, keeping 8 hours, KSM was according to 6 μg/kg？d phleb instillation, keeping 4 hours. 5-Fu was according to 26 mg/kg？d phleb instillation, keeping 8 hours. KSM was according to 6 μg/kg？d phleb instillation, keeping 4 hours. Both the two programs were 8 days. Results The cure rate was 98 % （54/55） in FUDR＋DSM group, and that was 96 % （54/56） in 5-Fu＋KSM group. The incidence rates of phlebophlogosis, dental ulcer and alopecie in the FUDR＋KSM group were obviously lower than those in 5-Fu＋KSM group [29.1 % （16/55） vs 85.7 % （48/56）, 54.5 % （30/55） vs 98.2 % （55/56）, 21.8 % （12/55） vs 89.3 % （50/56）, all P 〈 0.05]. Both the FUDR＋KSM group and the 5-Fu＋KSM group had significant differences at phlebophlogosis dental ulcer and alopecie in Ⅲ stages. Conclusion The curative effect of the FUDR is aimilar with the 5-Fu, but the drug consumption of the FUDR is less. The incidence rates of dental ulcer, alopecie, and phlebophlogosis are less, but myelosuppression and alvi profluvium are resemble between the two sets.