化疗联合手术治疗耐药性妊娠滋养细胞肿瘤的临床分析

doi:10.11904/j.issn.1002-3070.2020.01.010

Abstract

Abstract: Objective The Objective of this study was to explore the clinical effects of chemotherapy combined with surgery in patients with drug-resistant gestational trophoblastic neoplasia(GTN).Methods A total of 76 drug-resistant patients with high-risk GTN were selected and randomly divided into a control group and an observed group,each with 38 patients.Patients in the control group were treated with etoposide,methotrexate,and actinomycin-D/etoposide and cisplatin(EMA/EP),and patients in the observed group were treated with EMA/EP regimen combined with surgery.The treatment effect,prognosis,peripheral blood lymphocyte subsets and adverse reactions were compared between the control and observed groups.Results After 6 months of treatment,the ORR(Objective response rate)of the observed group was higher than that of the control group,and the difference was statistically significant(P=0.024).The drug resistance rate and recurrence rate in the observed group were lower than those in the control group(P＜0.05).There was no significant difference in serum HCG between the control and observed groups before treatment.The serum HCG levels in two groups decreased after treatment(P＜0.001).The serum HCG levels in the observed group at 6 months,12 months,and the last follow-up after treatment were lower than those in the control group(P＜0.001).There was no significant difference in the levels of T lymphocyte subsets between the two groups before treatment,and there were different degrees of improvement after 6 months of treatment.The CD3⁺,CD4⁺ and CD4⁺/CD8⁺T cells in the observed group were higher than those in the control group(P＜0.05).The incidence of neutropenia,hemoglobin reduction,nausea and vomiting,and hair loss in the observed group were lower than those in the control group(P＜0.05).Conclusion For patients with high-risk GTN in first-line drug-resistance,chemotherapy combined with surgery has a better therapeutic effect,and can effectively improve the body′s immune level and reduce the incidence of adverse reactions.

Key words: Gestational trophoblastic neoplasia, Chemotherapy, EMA/EP regimen, Objective response rate

CLC Number:

R737.33

LI Chunmei, LI Youfei, JIA Hongmei. Clinical analysis of chemotherapy combined with surgery for drug-resistant gestational trophoblastic tumors[J]. Journal of Practical Oncology, 2020, 34(1): 55-59.

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Clinical analysis of chemotherapy combined with surgery for drug-resistant gestational trophoblastic tumors

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