EMA/CO方案治疗高危妊娠滋养细胞肿瘤32例临床疗效观察

Observation on clinical efficacy of EMA /CO regimen in treatment of 32 high risk pregnant women with gestational trophoblastic neoplasia

目的:了解EMA/CO方案治疗高危妊娠滋养细胞肿瘤(GTN)的疗效和不良反应。方法:回顾性总结比较在新疆医科大学附属肿瘤医院32例应用EMA/CO方案和28例应用5-FU+KSM二联方案治疗高危GTN患者的临床疗效和不良反应。结果:EMA/CO方案在治疗高危GTN中治愈率可达93.75%,与5-FU+KSM二联方案相比疗效差异无统计学意义(P>0.05),但两组病例所需的平均疗程数和血清hCG降至正常所需的疗程数差异有统计学意义(P<0.05),EMA/CO方案可明显缩短化疗疗程;同时发现该方案的腹泻、静脉炎、色素沉着等化疗不良反应显著减少。结论:EMA/CO方案作为高危GTN的一线化疗方案,疗效肯定,不良反应轻,患者易于接受,具有临床应用推广价值。

Objective： To understand the curative effect and adverse reactions of EMA/CO regimen in treatment of 32 high risk pregnant women with gestational trophoblastic neoplasia （GTN） . Methods ： The curative effects and adverse reactions of 32 high risk GTN patients treated with EMA/CO regimen and 28 high risk GTN patients treated with 5 - FU ＋ KSM regimen in the hospital were summarized retrospectively and compared. Results： The cure rate of EMA/CO regimen was 93.75% , compared with 5 - FU ＋ KSM regimen, there was no statistically significant difference in the curative effect （ P 〉 0. 05 ）, but there were statistically significant differences in the mean number of course of treatment and the number of course of treatment for serum hCG reducing to normal level between the two regimens （P 〈 0. 05 ）, EMA/CO regimen could significantly shorten the course of chemotherapy, and the adverse reactions （ diarrhea, phlebitis, pigmentation） of EMA/CO regimen decreased significantly. Conclusion ： As the first - line chemotherapy for high risk GTN patients, the curative effect of EMA/CO regimen is good, the adverse reactions are mild, and the regimen is easy to be accepted by the patients, which has clinical applica- tion and promotion value.