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目的 探讨甲氨蝶呤-甲酰四氢叶酸钙(MTX-CF)方案治疗早期低危妊娠滋养细胞肿瘤(GTT)的有效性和安全性。方法 将1995年1月至2000年12月37例临床Ⅰ期的GTT病人随机分成两组:A组19例,B组18例。两组间在病种分布、平均年龄、化疗前血HCG水平和追加手术治疗等方面差异均无显著性意义(P>0.05)。A组采用MTX-CF方案;B组采用ACM三联序贯化疗。结果 A组和B组病例血清HCG降至正常所需的化疗疗程分别为2.11±1.20和2.28±1.07(P>0.05)。骨髓抑制、消化系统毒性反应以及脱发的发生率B组明显高于A组(P<0.05及P<0.01)。结论 针对临床Ⅰ期的GTT病人,采用MTX-CF方案化疗的近期疗效与ACM三联序贯疗法者相似,而前者的毒性反应明显低于后者。
Objective To investigate the efficacy and safety of methotrexate-leucovorin (MTX-CF) regimen in the treatment of gestational trophoblastic tumor at early gestational age (GTT). Methods From January 1995 to December 2000, 37 patients with clinical stage Ⅰ GTT were randomly divided into two groups: group A 19 cases, group B 18 cases. There was no significant difference between the two groups in disease distribution, mean age, HCG level before chemotherapy and additional surgical treatment (P> 0.05). A group using MTX-CF program; B group using ACM triple sequential chemotherapy. Results The courses of chemotherapy required for lowering serum HCG to normal in group A and group B were 2.11 ± 1.20 and 2.28 ± 1.07, respectively (P> 0.05). Bone marrow suppression, digestive toxicity and the incidence of hair loss in group B were significantly higher than those in group A (P <0.05 and P <0.01). Conclusions The immediate effect of MTX-CF regimen in patients with clinical stage I GTT is similar to that of ACM triple sequential therapy, while the former is significantly less toxic than the latter.