妊娠滋养细胞肿瘤(GTN)包括侵蚀性葡萄胎、绒毛膜癌、胎盘部位滋养细胞肿瘤和上皮样滋养细胞肿瘤,虽然总体治愈率达90%以上,但治疗不当的问题仍然存在。文章从化疗方案的选择、化疗副反应的处理、停止化疗的时机、手术的指征及价值等几方面阐述在临床上存在的对GTN患者治疗的过度与不足。 Gestational trophoblastic tumors (GTN) include invasive hydatidiform mole, choriocarcinoma, placental trophoblastic tumor and epithelioid trophoblastic tumor. Although the overall cure rate is above 90%, the problem of improper treatment still exists. This article describes the clinical over and under treatment of GTN patients from the aspects of the choice of chemotherapy regimens, the treatment of side effects of chemotherapy, the timing of stopping chemotherapy, the indications and the value of surgery.