Abstract:【Objective】To compare the efficacy and impact on pregnancy outcome of combination chemotherapy (BEP) with bleomycin (BLM), etoposide (VP-16), and cisplatin (DDP) with sequential chemotherapy (ACM) with actinomycin D (Act-D), cyclophosphamide (CTX), and methotrexate (MTX) in the treatment of patients with gestational trophoblastic neoplasia (GTN). 【Methods】A total of 102 patients with GTN admitted to our hospital from February 2020 to May 2021 were randomly divided into a BEP group (treated with BEP) and an ACM group (treated with ACM) according to a random number table method, with 51 patients in each group.The clinical efficacy, recovery time of sexual life, sexual function score, incidence of adverse reactions, pregnancy outcome, and ovarian function indicators [estradiol (E2), luteinizing hormone (LH), and follicle-stimulating hormone (FSH)] before and after treatment were compared between the two groups. 【Results】After treatment, there was no significant difference in the total effective rate between the two groups (χ2=1.041,P=0.308). After treatment, the levels of E2, LH, and FSH in both groups decreased (P<0.05), but the levels of E2, LH, and FSH in the ACM group were higher than those in the BEP group (P<0.05). There was no significant difference in the recovery time of sexual life and sexual function score between the two groups after chemotherapy (t=0.293, 1.814, P=0.770, 0.073). The total incidence of adverse reactions in the two groups was similar (χ2=1.055, P=0.316). The pregnancy success rate in the ACM group was higher than that in the BEP group (χ2=4.767, P<0.05).【Conclusion】 The efficacy of combination chemotherapy (BEP) and sequential chemotherapy (ACM) for the treatment of gestational trophoblastic neoplasia (GTN) is comparable, and the incidence of adverse reactions is similar, but sequential chemotherapy (ACM) has less impact on the ovarian function of patients with GTN, which is beneficial to improving the pregnancy success rate after treatment.
刘利英, 翟瑶, 张恒瑜. BEP与ACM化疗方案治疗滋养细胞肿瘤患者的疗效对比[J]. 医学临床研究, 2023, 40(12): 1885-1888.
LIU Liying,ZHAI Yao,ZHANG Hengyu. Comparison of the Efficacy of BEP and ACM Chemotherapy Regimens in the Treatment of Patients with Trophoblastic Tumors. JOURNAL OF CLINICAL RESEARCH, 2023, 40(12): 1885-1888.
[1] SOPER J T. Gestational Trophoblastic disease: current evaluation and management[J].Obstet Gynecol,2021, 137(2):355-370. [2] EIRIKSSON L, DEAN E, SEBASTIANELLI A, et al. Guideline No. 408: management of gestational trophoblastic diseases[J].J Obstet Gynaecol Can,2021, 43(1):91-105. [3] 宋水勤, 张国楠. BEP方案治疗高危型妊娠滋养细胞肿瘤的疗效及安全性评价[J].中华妇产科杂志, 2012,47(8):571-576. [4] 卞倩, 杨淑梅, 杨亮. 三联序贯方案治疗滋养细胞肿瘤对卵巢功能及疗效的影响[J].中国肿瘤临床与康复, 2020, 27(5):532-535. [5] 王丽娟, 冯凤芝, 林仲秋.《2020 NCCN妊娠滋养细胞肿瘤临床实践指南(第一版)》解读[J].中国实用妇科与产科杂志, 2020, 36(1):74-79. [6] 张百红, 岳红云. 实体瘤疗效评价标准简介[J].国际肿瘤学杂志, 2016, 43(11):845-847. [7] FAKHRI A, PAKPOUR A H, BURRI A, et al. The Female Sexual Function Index: translation and validation of an Iranian version[J].J Sex Med,2012, 9(2):514-523. [8] MILLER T P, FISHER B T, GETZ K D, et al. Unintended consequences of evolution of the Common Terminology Criteria for Adverse Events[J].Pediatr Blood Cancer,2019, 66(7):277-284. [9] BRAGA A, ELIAS K M, HOROWITZ N S, et al. When less is more: regarding the use of chest X-ray instead of computed tomography in screening for pulmonary metastasis in postmolar gestational trophoblastic neoplasia[J].Br J Cancer,2021, 124(6):1033-1034. [10] 徐臻, 王璐, 杨琳俐, 等. 5-氟尿嘧啶联合顺铂、长春新碱治疗妊娠滋养细胞肿瘤的疗效分析[J].现代妇产科进展, 2021, 30(5):355-359. [11] 毕尚雨, 杨甫, 靳瑾, 等. 氟脲苷+放线菌素D方案初始治疗妊娠滋养细胞肿瘤的疗效及其影响因素分析[J].中华妇产科杂志, 2020, 55(12):865-869. [12] 康海利, 赵群, 吴玉梅, 等. 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[J].山东医药, 2021, 61(18):5-9. [13] 蒋诗阳, 赵峻. 妊娠滋养细胞肿瘤保留生育功能治疗的研究进展[J].中国癌症防治杂志, 2020, 12(2):149-154. [14] 王芬芬, 程晓东. 妊娠滋养细胞肿瘤保留生育功能治疗策略[J].中国临床医生杂志, 2020, 48(4):408-412. [15] 中国抗癌协会妇科肿瘤专业委员会.妊娠滋养细胞疾病诊断与治疗指南(2021年版)[J].中国癌症杂志, 2021, 31(6):520-532.