5-Fu、MTX、VP16-213联合方案治疗恶性妊娠滋养细胞肿瘤的研究

5-Fu、MTX、VP16-213 Regime in the treatment of gestational trophoblastic tumor.

目的 探讨 5 -Fu、MTX、VP16 - 2 13联合化学治疗恶性妊娠滋养细胞肿瘤患者的疗效。方法 对1992年 4月至 2 0 0 3年 4月 11年本院 91例恶性妊娠滋养细胞肿瘤 (包括侵蚀性葡萄胎和绒癌 )患者采用 5 -Fu、MTX、VP16 - 2 13三联化疗方案治疗 ,其中绒癌 36例 ,有 2例为复发性绒癌 ;侵蚀性葡萄胎 (侵葡 ) 5 5例。Ⅰ期 16例 ,Ⅱ期 2 6例 ,Ⅲ期 5 6例。结果 91例患者中 ,采用此三联化疗方案治疗有 86例获治愈 ,总治愈率高达 94 5 1%。此三联化疗方案的主要毒副反应是骨髓抑制和胃肠道反应 ,其中Ⅲ～Ⅳ度粒细胞减少占2 7 3% ,Ⅲ～Ⅳ度血小板减少占 7 4 % ,Ⅲ度恶心呕吐占 19 8% ,Ⅲ度腹泻占 2 4 % ,Ⅰ度肝功损害占 2 1% ,在 19 6 9%的疗程中发生口腔溃疡 ,其中Ⅲ度占 8 36 %。结论 5 -Fu、MTX、VP16 - 2 13联合方案治疗恶性妊娠滋养细胞肿瘤可达满意的临床效果 。

Objective To discuss the application of the regime combining 5-Fu、MTX with VP16-213 in treatment of gestational trophoblastic tumor.Methods A total of 91 cases of gestational trophoblastic neoplasm treated by 5-Fu、MTX、VP16-213 regime during the period of April, 1992 to April, 2003 at the First Hospital of Xi'an Jiaotong University was retrospectively analyzed. Results Eighty six of the total 91 cases which were treated by the consociated regimen has been completely cured, with 94.51% healing rate. On the other hand,this regimen has the side-effect of marrow suppression and gastric intestinal disorder, and of all, there are 27.3% granulocytopenia of Ⅲ～Ⅳ degree, 7.4% thrombocytopenia of Ⅲ～Ⅳ degree, severe nausea and vomiting of 19.8%,severe diarrhea of 3.4%, liver dysfunction of 2.1%,19.69% oral ulcer in which about 8.36% are Ⅲ degree ones.Conclusion Offered to the cases of gestationa1 trophoblastic neoplasm, the alliance regime of 5-Fu、MTX、VP16-213 could get the satisfied clinical effect, and could reach good results for the chemotherapy resistant or recurrent cases.