甲氨蝶呤单药治疗低危妊娠滋养细胞肿瘤的疗效及其相关因素

发布时间：2019-04-26 07:25

【摘要】：目的探讨采用新的FIGO临床分期后,甲氨蝶呤(MTX)单药治疗低危妊娠滋养细胞肿瘤(GTN)的疗效及其相关影响因素。方法收集本院2001年1月至2009年12月收治的133例符合条件的低危GTN患者的临床资料并进行回顾性分析,所有患者均按照2000年国际妇产科联盟(FIGO)临床分期标准重新进行评分,对患者年龄、前次妊娠性质、距前次妊娠间隔时间、化疗前血HCG水平、最大病灶大小、转移灶数目、临床分期和预后评分、是否合并手术与其疗效进行单因素和多因素分析。结果 133例患者中有100例(75.2%)经MTX化疗后达到完全缓解,余33例经补救化疗后均达到完全缓解。单因素分析和二分类Logistic回归多因素分析,均显示FIGO预后评分及化疗前血HCG水平与MTX单药初次化疗疗效显著相关。FIGO预后评分小于等于4分患者的113例患者中23例(20.35%)出现耐药,而大于4分的20例患者中10例(50%)出现耐药。结论在采用新的FIGO临床分期后,MTX单药化疗对于低危GTN而言仍是一种有效的治疗方案。FIGO预后评分、化疗前血HCG水平是影响MTX单药化疗疗效的独立因素。
[Abstract]:Objective to investigate the efficacy of methotrexate (MTX) in the treatment of low-risk gestational trophoblastic tumors (GTN) and its related factors after the new clinical stage of FIGO. Methods the clinical data of 133 patients with low-risk GTN admitted to our hospital from January 2001 to December 2009 were collected and analyzed retrospectively. All patients were re-graded according to the International Union of Gynecology and Obstetrics (FIGO) clinical staging criteria in 2000. The age of the patient, the nature of the previous pregnancy, the interval from the previous pregnancy, the level of HCG in the blood before chemotherapy, the maximum focus size, and the number of metastatic foci were evaluated. Univariate and multivariate analysis were performed on the clinical stage and prognosis score, whether or not the operation was combined with its curative effect. Results 100 cases (75.2%) achieved complete remission after MTX chemotherapy, and the rest 33 cases achieved complete remission after remedial chemotherapy. Univariate analysis and binary Logistic regression multivariate analysis, The prognosis score of FIGO and the level of serum HCG before chemotherapy were significantly correlated with the effect of primary chemotherapy of MTX. Of the 113 patients with Figo prognosis score less than or equal to 4 points, 23 (20.35%) were resistant to drugs, and the drug resistance was found in 23 patients (20.35%) with Figo prognosis score less than 4. Of the 20 patients with scores greater than 4, 10 (50%) developed drug resistance. Conclusion after the new clinical stage of FIGO, MTX single drug chemotherapy is still an effective therapy for low-risk GTN. Figo prognosis score, the level of HCG before chemotherapy is an independent factor affecting the efficacy of MTX single-drug chemotherapy. [WT5 "HZ] conclusion:\?
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.33

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