Gillespie A M, Siddiqui N, Coleman R E, Hancock B W
Gestational Trophoblastic Disease Screening and Treatment Centre, Yorkshire Cancer Research, Department of Clinical Oncology, Weston Park Hospital, Sheffield.
Br J Cancer. 1999 Mar;79(7-8):1270-2. doi: 10.1038/sj.bjc.6690203.
In the UK there are standardized surveillance procedures for gestational trophoblastic disease. However, there are differences in practice between the two treatment centres in terms of definition of persistent gestational trophoblastic disease, prognostic risk assessment and chemotherapeutic regimens. The role of prophylactic chemotherapy for cerebral micrometastatic disease in persistent gestational trophoblastic disease is unclear. We have analysed the outcome of 69 patients with lung metastases who elsewhere might have received prophylactic intrathecal chemotherapy. Of the 69 patients, 67 received intravenous chemotherapy only. The other two patients had cerebral metastases at presentation. One patient who received only intravenous chemotherapy subsequently developed a cerebral metastasis, but this patient's initial treatment was compromised by non-compliance. This experience supports our current policy of not treating patients with pulmonary metastases, without clinical evidence of central nervous system (CNS) involvement, with prophylactic intrathecal therapy.
在英国，对于妊娠滋养细胞疾病有标准化的监测程序。然而，两个治疗中心在持续性妊娠滋养细胞疾病的定义、预后风险评估和化疗方案方面存在实际差异。预防性化疗对持续性妊娠滋养细胞疾病中脑微转移疾病的作用尚不清楚。我们分析了69例有肺转移的患者的治疗结果，这些患者在其他地方可能接受了预防性鞘内化疗。在这69例患者中，67例仅接受了静脉化疗。另外两名患者在就诊时已有脑转移。一名仅接受静脉化疗的患者随后发生了脑转移，但该患者的初始治疗因不依从性而受到影响。这一经验支持了我们目前的政策，即对于没有中枢神经系统（CNS）受累临床证据的肺转移患者，不采用预防性鞘内治疗。
