FAV方案和FAEV方案作为初始方案治疗高危型妊娠滋养细胞肿瘤的疗效比较

发布时间：2018-07-09 16:40

本文选题：妊娠滋养细胞肿瘤 + 化疗　；参考：《实用妇产科杂志》2015年03期

【摘要】：目的:探讨FAV方案(氟脲苷+放线菌素D+长春新碱)和FAEV方案(氟脲苷+放线菌素D+依托泊苷+长春新碱)作为初始化疗方案治疗高危型妊娠滋养细胞肿瘤(GTN)的效果。方法:回顾性分析2005年1月至2013年12月在北京协和医院接受初次化疗且首选方案为FAV方案(FAV组,32例)或FAEV方案(FAEV组,42例)的高危型GTN患者的治疗情况,并比较两组治疗方案的疗效。结果:FAV组和FAEV组达到血清学完全缓解(SCR)的患者分别为21例和30例(65.6%vs71.4%,P=0.59),其中FAV组有2例复发,FAEV组无复发(9.5%vs 0,P=0.17)。FAV组和FAEV组对化疗耐药(NR)的患者分别为9例和6例(28.1%vs 14.3%,P=0.14),因难以耐受化疗副反应而更改方案的患者分别为2例和6例(6.3%vs 14.3%,P=0.27)。两组中的耐药患者和出现难以耐受化疗副反应的患者经过更换化疗方案,并且部分患者接受辅助手术治疗后均获得SCR。FAV组中耐药患者,FAEV、EMA-CO和EMA-EP 3种方案的SCR率分别为42.9%(3/7)、71.4%(5/7)和50.0%(1/2)。FAEV组中耐药患者,EMA-CO和EMA-EP方案的SCR率分别为66.7%(4/6)和100.0%(2/2)。结论:FAV和FAEV方案作为高危型GTN患者的一线治疗方案是有效的,两种方案的疗效和患者耐受性无明显差异。对于FAV或FAEV方案耐药的高危型GTN患者,EMA-CO均可作为理想的二线化疗方案。
[Abstract]:Objective: to investigate the effect of FAV regimen (fluoren D vincristine) and FAEV regimen (fluorouractin D etoposide vincristine) in the treatment of high-risk gestational trophoblastic neoplasms (GTN). Methods: from January 2005 to December 2013, patients with high risk GTN were treated with FAV regimen (FAV group, n = 32) or FAEV regimen (group FAEV, n = 42). The therapeutic effects of the two groups were compared. Results 21 and 30 patients (65.6 vs 71.4 and 0.59) achieved complete serological remission (SCR) in the Fav-FAV group and the FAEV group, respectively. Among them, 2 cases in the FAV group had no recurrence (9.5%vs 0 P0. 17). 9 cases in the FAV group and 6 cases in the FAEV group were resistant to chemotherapeutic resistance (NR) (28.1%vs 14.3P 0.14). The number of patients who changed the regimen to tolerate side effects of chemotherapy was 2 and 6 respectively (6.3%vs 14.3 and P0. 27). In both groups, drug-resistant patients and patients with adverse reactions to chemotherapy were replaced by chemotherapy protocols. The SCR rates of EMA-CO and EMA-EP regimen in SCR.FAV group were 42.9% (3 / 7) 71.4% (5 / 7) and 50.0% (1 / 2). The SCR rates of EMA-CO and EMA-EP were 66.7% (4 / 6) and 100.0% (2 / 2), respectively. Conclusion the two regimens, FAV and FAEV, are effective as a first-line treatment for high risk GTN patients, and there is no significant difference in the efficacy and patient tolerance between the two regimens. EMA-CO for high risk GTN patients with FAV or FAEV regimen resistance can be regarded as an ideal second line chemotherapy regimen.
【作者单位】：中国医学科学院北京协和医学院北京协和医院;
【分类号】：R737.33

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