妊娠滋养细胞肿瘤的化疗方案疗效评价

Effect of different chemotherapies for gestational trophoblastic neoplasia

目的总结分析5-氟尿嘧啶（5-fluorouracil,5-Fu）联合更生霉素化疗及替加氟联合更生霉素化疗方案治疗妊娠滋养细胞肿瘤的疗效。方法选择2003年1月至2013年1月在我院使用5-Fu联合更生霉素化疗及替加氟联合更生霉素方案治疗妊娠滋养细胞肿瘤的患者共104例,随访时间12∽72个月。分析两组化疗方案的疗效及其对骨髓抑制、消化道反应及肝功能的影响。结果该方案治疗的104例妊娠滋养细胞肿瘤患者中,侵蚀性葡萄胎治愈率为92.5%,绒癌治愈率为66.7%。两种化疗方案出现骨髓抑制及消化道反应的疗程数比较差异有统计学意义,而二者对肝功能的影响比较差异无统计学意义（P〉0.05）。结论替加氟联合更生霉素方案可作为妊娠滋养细胞肿瘤的一线化疗方案,其疗效肯定,毒性反应小,适合临床应用。

Objective To summarize and analyze the effect of 5-fluorouracil（ 5-Fu） combined with dactinomycin and ftorafur combined w ith dactinomycin in the treatment of gestational trophoblastic neoplasia. Methods 104 cases of gestational trophoblastic neoplasia patients treated w ith 5-Fu combined w ith dactinomycin and ftorafur combined w ith dactinomycin from January 2003 to January 2013 in our hospital w ere selected,and they w ere follow ed up for 12 ∽ 72 months. The effects of chemotherapy,bone marrow suppression,gastrointestinal reaction and liver function of the tw o groups w ere analyzed. Results The cure rates of invasive mole and choriocarcinoma w ere 92. 5% and66. 7%. There w ere significant differences in the number of course w ith adverse effects of bone marrow suppression and gastrointestinal reaction betw een the tw o chemotherapy groups（ P〈0. 05）,w hile there w as no significant difference in liver dysfunction（ P〈0. 05）. Conclusion Ftorafur combined with dactinomycin can be used as first-line chemotherapy for gestational trophoblastic neoplasia with good efficacy and little toxic reaction,it is suitable for clinical application.