BEP与ACM化疗方案治疗滋养细胞肿瘤患者的疗效对比

Comparison of the Efficacy of BEP and ACM Chemotherapy Regimens in the Treatment of Patients with Trophoblastic Tumors

【目的】对比博莱霉素(BLM)、依托泊苷(VP-16)、顺铂(DDP)联合化疗(BEP)与放线菌-D(Act-D)、环磷酰胺(CTX)、甲氨蝶呤(MTX)三联序贯化疗(ACM)治疗滋养细胞肿瘤(GTN)患者的疗效及对妊娠结局的影响。【方法】选取2020年2月至2021年5月本院收治的102例GTN患者,按照随机数字表法分为BEP组(给予BEP治疗)和ACM组(给予ACM治疗),每组51例。比较两组患者临床疗效、性生活恢复时间、性功能评分、不良反应发生率、妊娠结局及治疗前后卵巢功能指标[雌二醇(E_(2))、黄体生成素(LH)及卵泡雌激素(FSH)]。【结果】治疗后,两组总有效率比较,差异无统计学意义(χ^(2)=1.041,P=0.308)。治疗后,两组患者E_(2)、LH及FSH水平均降低(P<0.05),但ACM组E_(2)、LH及FSH水平均高于BEP组(P<0.05)。两组化疗后性生活恢复时间、性功能评分比较,差异无统计学意义(t=0.293、1.814,P=0.770、0.073)。两组不良反应总发生率比较,差异无统计学意义(χ^(2)=1.055,P=0.316)。ACM组妊娠成功率高于BEP组(χ2=4.767,P<0.05)。【结论】BEP、ACM化疗方案治疗GTN的疗效相当,不良反应发生率接近,但ACM化疗对GTN患者的卵巢功能影响较小,有利于提高治疗后妊娠成功率。

【Objective】To compare the efficacy and impact on pregnancy outcome of combination chemotherapy(BEP)with bleomycin(BLM),etoposide(VP-16),and cisplatin(DDP)with sequential chemotherapy(ACM)with actinomycin D(Act-D),cyclophosphamide(CTX),and methotrexate(MTX)in the treatment of patients with gestational trophoblastic neoplasia(GTN).【Methods】A total of 102 patients with GTN admitted to our hospital from February 2020 to May 2021 were randomly divided into a BEP group(treated with BEP)and an ACM group(treated with ACM)according to a random number table method,with 51 patients in each group.The clinical efficacy,recovery time of sexual life,sexual function score,incidence of adverse reactions,pregnancy outcome,and ovarian function indicators[estradiol(E_(2)),luteinizing hormone(LH),and follicle-stimulating hormone(FSH)]before and after treatment were compared between the two groups.【Results】After treatment,there was no significant difference in the total effective rate between the two groups(χ^(2)=1.041,P=0.308).After treatment,the levels of E_(2),LH,and FSH in both groups decreased(P<0.05),but the levels of E_(2),LH,and FSH in the ACM group were higher than those in the BEP group(P<0.05).There was no significant difference in the recovery time of sexual life and sexual function score between the two groups after chemotherapy(t=0.293,1.814,P=0.770,0.073).The total incidence of adverse reactions in the two groups was similar(χ^(2)=1.055,P=0.316).The pregnancy success rate in the ACM group was higher than that in the BEP group(χ^(2)=4.767,P<0.05).【Conclusion】The efficacy of combination chemotherapy(BEP)and sequential chemotherapy(ACM)for the treatment of gestational trophoblastic neoplasia(GTN)is comparable,and the incidence of adverse reactions is similar,but sequential chemotherapy(ACM)has less impact on the ovarian function of patients with GTN,which is beneficial to improving the pregnancy success rate after treatment.