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目的 :前瞻性观察卡铂联合甲氨喋呤、长春新碱治疗恶性滋养细胞肿瘤的疗效和副反应。方法 :采用卡铂联合方案对 4 1例初治和 9例耐药的恶性滋养细胞肿瘤进行治疗 ,其疗效和副反应与同期用 5Fu加KSM治疗的 4 0例初治病例做对照。结果 :对初治病例观察组和对照组的治愈率分别 10 0 %和 90 % ,差异无显著意义 (P >0 0 5 ) ,但观察组HCG降至正常和达治愈标准所需的平均疗程数仅为 1 88和 2 71,明显少于对照组的 2 81和 3 3 1( P <0 0 1和 P <0 0 1) ;对 9例耐药病例用卡铂联合方案治疗后有 8例获得治愈 ,平均疗程为 2 88。化疗中发生呕吐和腹泻的疗程 ,观察组占 2 8 8%和 1 4 %明显低于对照组的 74 0 %和 9 3 % (P <0 0 0 1和P <0 0 1) ,而骨髓抑制情况两组相似。结论 :卡铂联合方案治疗恶性滋养细胞肿瘤具有疗效好、疗程短、副反应轻 ,对耐药病例亦有较好的疗效等优点。
Objective: To prospectively observe the efficacy and side effects of carboplatin combined with methotrexate and vincristine in the treatment of malignant trophoblastic tumors. Methods: A total of 41 untreated and 9 drug resistant malignant trophoblastic tumors were treated with carboplatin regimen. The curative effect and side effects were compared with 40 untreated cases treated with 5Fu and KSM over the same period. Results: The cure rates of observation group and control group were 100% and 90%, respectively, with no significant difference (P> 0.05). However, the average course of HCG in observation group decreased to normal and reached the standard of cure The numbers were only 1 88 and 2 71, which were significantly lower than those of the control group 2 81 and 3 3 1 (P 0 01 and P 0 01). Nine of the 9 resistant cases were treated with carboplatin regimen Cases were cured, the average course of 2 88. Vomiting and diarrhea occurred during chemotherapy, with 28.8% and 14% in the observation group being significantly lower than 74 0% and 93% in the control group (P <0.01 and P <0.01), while the bone marrow Inhibition was similar between the two groups. Conclusion: The combination of carboplatin in the treatment of malignant trophoblastic tumor has the advantages of good curative effect, short course of treatment, mild side effects and good curative effect to resistant cases.