摘要
[目的]评价卡铂、甲氨喋呤、长春新碱联合化疗（CMV方案)对妊娠绒癌的疗效、副作用和其优缺点。[方法]对1994年1月至1998年3月22例绒癌病例进行回顾性分析，总结近期治愈率和总有效率，观察其毒副作用。22例绒癌实施总疗程104个。[结果]初用CMV方案者10例，治愈7例，有效2例，耐药1例。既往曾用其他方案化疗失败又改用CMV方案者12例，治愈5例，有效7例。近期治愈率54.55％，总有效率达95．46%，其中既往化疗无效者的近期治愈率是41.67％。6例单纯行化疗，16例除化疗外辅加子宫切除术和肺叶切除术治疗。恶心、呕吐、口腔溃疡为最常见副反应，经对症处理均可耐受化疗，中途停药或延长间歇期者均为肝功能受损，经保肝处理好转。对骨髓抑制者，经粒细胞集落刺激因子治疗WBC在短期即恢复，红细胞减少为轻中度，不影响化疗。未发现耳肾毒性。［结论]CMV联合化疗方案是治疗妊娠绒癌的有效方案，为临床医生治疗妊娠绒癌提供了新的选择；同时，病人耐受良好、易于接受。
[Purpose] To evaluate the effect, toxicity, advantage and disadvantage of chemotherapy with carboplatinum-methotrexate-vinchstine(CMV) for women with gestational choriocarcinoma. [ Methods] Retrospective analysis of 22 case records between January 1994 and March1998 was carried out. The cure rate and effect of the chemotherapy with CMV were analysed. The toxicity were identified. Twenty - two me withgestational choriocarcinoma received 104 cycles of the CMV regimen. [Result]Among 10 women for primary chemotherapy/were cured and 2 wereeffective and one was in drug resistance. of 12 secondary therapy patients,5 were cured,7 were effective. The cure rate w 54.55%,the over - allresponse rate was 95 .46%. The cure rate of secondary therapy was 41. 67%. Six patients received chemotherapy alone. Sixteen patients were treatedfor chemotherapy with hysterectomy and pulmonary wedge resection. Stomatitis was most commonly toxicity but the patients could be tolerable. Theneutropenia can recovered by colonystimulating treatment. Anemia was wild or midding and did not affect thempy. There were no nephritic and auraltoxicity. There was no life threatening toxicity. [Conclusion] The regimen of carboplatinmu-methonde - vincristine is tave and well-tolendedfor patients with gestational choriocarcinoma. It is a new choice for clinital doctors and patients.
关键词
妊娠绒癌
药物疗法
副作用
卡铂
治疗
Gestational choriocarcinoma Drug therapy Toxicity Carboplatinum
