放线菌素D、甲氨蝶呤、放线菌素D联合甲氨蝶呤、 BEP化疗方案治疗低危滋养细胞肿瘤对比观察.

Objective To compare the efficacy and safety of actinomycin D（ACT), methotrexate（MTX), ACTD + MTX，and bleomycin，etoposide and cisplatin（BEP）in the treatment of low-risk trophoblastic neoplasia（LR-GTN） with a score of 5-6 points graded by International Federation of Gynecology and Obstetrics（FIGO）. Methods Totally 42 patients with LR-GTN with a score of 5-6 points graded by FIGO were divided into the MTX group（n=9) ACTD group（n =10），MTX+ACTD group（n=14），and BEP group（n=9). Patients in the MTX group were injected with 0. 4 mg/（Kg· d）MTX intramuscularly for 5 consecutive days with the interval of 2 weeks. Patients in the ACTD group were instilled with 10-12 μg/（Kg·d）ACTD intravenously for 5 consecutive days with the interval of 2 weeks. Patients in the MTX+ ACTD group were instilled with 8 μg/（Kg·d）ACTD in 500 mL 5% glucose injection intravenously for 5 consecutive days，and were injected with 25 mg MTX into the cervix uteri 3 times in total with the interval of 2 weeks. The BEP group was treated with BEP regimen：patients were instilled with 1. 5 mg bleomycin intravenously for 3 days，100 mg/m² etoposide for 4 days, and 20 mg/m² cisplatin for 4 days with the interval of 3 weeks. We determined the efficacy in each group and recorded the occurrence of adverse reactions in each group. Results Patiehts in the MTX group, the ACTD group, the MTX+ACTD group and the BEP group were treated for 8（8，9), 8（8，9), 6（6，7), 6（6，7）courses respectively. The effective rates of treatment in the MTX group，ACTD group, MTX+ACTD group，and BEP group were 22. 2%（2/ 9），30. 0%（3/10），71. 4%（10/14), and 77. 8%（7/9）respectively. Compared with the ACTD group and the MTX group，the ACTD+MTX group and the BEP group had higher effective treatment rates（all P<0. 05）. Compared with the BEP group, the incidence of hair loss and grade 3/4 thrombocytopenia was lower in the ACTD+MTX group（all P< 0. 05）. Conclusions ACTD+MTX and BEP regimens have higher efficiency in patients with LR-GTN FIGO 5-6 points. Patients treated with ACTD+MTX regimen have less adverse reactions. [ABSTRACT FROM AUTHOR]