氟尿嘧啶脱氧核苷单药、联合方案治疗妊娠滋养细胞肿瘤患者的疗效

Floxuridine-containing Regime in the Treatment of Gestational Trophoblastic Tumor

目的探讨氟尿嘧啶脱氧核苷(floxuridine,FUDR)单药、联合方案治疗妊娠滋养细胞肿瘤患者的疗效。方法对1999年4月～2002年12月本院74例妊娠滋养细胞肿瘤患者采用FUDR单药、联合方案化疗,其中侵袭性葡萄胎47例,绒癌27例;Ⅰ期33例,Ⅱ期3例,Ⅲa期31例,Ⅲb期6例,Ⅳ期1例。21例系对5-FU或MTX单药、联合方案出现耐药后而改用FUDR单药、联合方案患者。结果74例患者中,通过FUDR单药、联合方案获治愈68例(91.9%),其中21例对5-FU或MTX单药、联合方案耐药而改用FUDR单药、联合方案的患者均获完全缓解,7例Ⅲb期以上的晚期患者亦均获治愈。FUDR单药、联合方案的主要副反应为骨髓抑制和胃肠道反应,其中Ⅲ～Ⅳ度粒细胞减少占26%,Ⅲ～Ⅳ度血小板减少占6.2%,Ⅲ度恶心呕吐占57.1%,Ⅲ度腹泻占4.3%。结论FUDR单药、联合方案治疗妊娠滋养细胞肿瘤可达满意的临床效果,对其他药物耐药或晚期病例也可获得满意的疗效。

To analyse the efficacy of the floxuridine(FUDR)-containing regime (single agent or in combination)in the treatment of gestational trophoblastic tumor.Methods Seventy-four patients with gestational trophoblastic tumors(GTT),47invasive mole and27choriocarcinoma,were treated with FUDR-containing regime.The clinical staging of the disease were:33cases of stageⅠ,3cases of stageⅡ,31cases of stageⅢa,6cases of stageⅢb,and1case of stageⅣ.Results The cure rate of FUDR-containing regime in the treatment of GTT was91.9%(68out of74cases).Twenty-one out of these74patients showed drug resistant to5-FU-containing or MTX-containing regime and were cured after they changed to the FUDR-containing regime.All7patients of advanced stage(≥Ⅲb)got cured.The major adverse event of FUDR-containing regime was myelodepression and gastrointestinal toxicity:Ⅲ～Ⅳdegree granulopenia26%,Ⅲ～Ⅳthrombopenia6.2%,Ⅲdegree vomiting57.1%,andⅢdegree diarrhea4.3%.Conclusion FUDR-containing regime is efficient for the treatment of GTT,even for those with advanced stage or drug-resistant disease.