【摘要】 目的:评价紫杉醇联合铂类药物化疗方案治疗持续耐药及复发性妊娠滋养细胞肿瘤(GTN)患者的疗效及安全性。方法:回顾性分析2006年1月至2013年1月,在北京协和医院接受紫杉醇联合铂类化疗方案治疗的25例持续耐药及复发性GTN患者的治疗情况及最终治疗结局。结果:25例持续耐药及复发性GTN患者共接受了115疗程的紫杉醇联合铂类的化疗方案,平均每例4.6±2.2(2~10)疗程,具体包括紫杉醇+顺铂(TP)方案52疗程、紫杉醇+卡铂(TC)方案56疗程及紫杉醇+依托泊苷/紫杉醇+顺铂(TE/TP)方案7疗程。在停止化疗时,血清学完全缓解14例,部分缓解4例,治疗无效7例,完全缓解率为56.0%(14/25),总缓解率为72.0%(18/25),血清学完全缓解后的复发率为35.7%(5/14),平均复发时间为95.4±18.4天(约3.2个月)。紫杉醇联合铂类方案的毒副反应主要为骨髓抑制、消化道反应、肝肾损伤及过敏等,发生Ⅲ~Ⅳ度骨髓抑制患者比例为48.0%,未发生致死性副反应。结论:紫杉醇联合铂类对持续耐药及复发性GTN患者是可供选择的化疗方案。更多还原

【Abstract】 Objective: To evaluate the efficacy of paclitaxel combined platinum on persistent chemoresistent or reccurent gestational trophoblastic neoplasm( GTN). Methods: The treatment and prognosis of twenty-five patents with persistent chemoresistent or reccurent GTN in Peking Union Medical College Hospital from Jan2006 to Jan 2013 were analyzed retrospectively. Results: Twenty-five patients received a total of 115 courses of chemotherapy containing paclitaxel and—platinum,including 52 courses of regimens of paclitaxel + cisplatin( TP),56 courses of paclitaxel +carboplatin( TC) and 7 courses of paclitaxel +etoposide / paclitaxel + cisplatin( TE /TP),and the mean number of course for each patient was 4. 6 ±2. 2( 2-10). Fifteen patients got complete serological remission,four got partial remission and seven failed in the courses,with a remission rate of 72. 0%( 18 /25). 5 of the 14 patients with complete remission( 35. 7%) relapsed after therapy,and the mean interval was 95 days. The major complications for paclitaxel and platinum regimens included myelosuppression,gastrointestinal symptoms,hepatic function damage and allergy. The incidence of Ⅲ-Ⅳ grade myelosuppression was 48. 0%,lacking of lethal side effect. Conclusions: As an alternative regimen,the paclitaxel combined platinum is effective and well-tolerated for persistent chemoresistent and recurrent GTN.更多还原