Xue Y, Zhang J, Wu T X, An R F
Cochrane Database Syst Rev. 2006 Jul 19(3):CD005196. doi: 10.1002/14651858.CD005196.pub2.
Gestational trophoblastic disease (GTD) includes gestational trophoblastic tumour and hydatidiform mole. Many women of reproductive age are affected by this disease although its incidence differs by geographical location. A number of chemotherapy regimens are used for treating the disease, such as methotrexate, actinomycin D and cyclophosphamide (MAC), methotrexate, actinomycin D, cyclophosphamide, doxorubicin, melphalan, hydroxyurea and vincristine (CHAMOC), etoposide, methotrexate and actinomycin (EMA) plus cyclophosphamide and vincristine (CO) (EMA-CO), etoposide, methotrexate and actinomycin (EMA) plus etoposide and cisplatin(EP) (EMA-EP). The efficacy of these drugs has not been systematically reviewed.
To determine the efficacy and safety of combination chemotherapy in treating high-risk GTT.
Electronic searches of MEDLINE, EMB, Cochrane Central Register of Controlled Trials (CENTRAL) and CBM were carried out. Four journals were handsearched and other searching methods were used for identifying more studies.
The review included randomized controlled trials (RCTs) or quasi-RCTs of combination chemotherapy for treating high-risk GTT. Patients with placental-site trophoblastic tumour (PSTT), who had received chemotherapy in the previous two weeks, or patients with chemotherapy intolerance were excluded.
Two investigators independently collected data using a data extraction form. Meta-analysis was not performed and the review was conducted as a narrative review.
One study with 42 participants was included in this review. It indicated that a MAC regimen was better than a CHAMOCA regimen for high-risk GTT because of lower toxicity. The quality of the study was unclear.
AUTHORS' CONCLUSIONS: The methodological limitations of the included study prevent any firm conclusions about the best combination chemotherapy regimen for high-risk GTT. High quality studies are required.
妊娠滋养细胞疾病（GTD）包括妊娠滋养细胞肿瘤和葡萄胎。尽管其发病率因地理位置而异，但许多育龄妇女受此疾病影响。多种化疗方案用于治疗该疾病，如甲氨蝶呤、放线菌素D和环磷酰胺（MAC）、甲氨蝶呤、放线菌素D、环磷酰胺、阿霉素、美法仑、羟基脲和长春新碱（CHAMOC）、依托泊苷、甲氨蝶呤和放线菌素（EMA）加环磷酰胺和长春新碱（CO）（EMA - CO）、依托泊苷、甲氨蝶呤和放线菌素（EMA）加依托泊苷和顺铂（EP）（EMA - EP）。这些药物的疗效尚未得到系统评价。
确定联合化疗治疗高危妊娠滋养细胞肿瘤（GTT）的疗效和安全性。
对MEDLINE、EMB、Cochrane对照试验中央注册库（CENTRAL）和中国生物医学文献数据库（CBM）进行了电子检索。手工检索了4种期刊，并采用其他检索方法来识别更多研究。
该综述纳入了治疗高危GTT的联合化疗的随机对照试验（RCT）或半随机对照试验。排除在过去两周内接受过化疗的胎盘部位滋养细胞肿瘤（PSTT）患者或化疗不耐受患者。
两名研究者使用数据提取表独立收集数据。未进行荟萃分析，该综述以叙述性综述的形式进行。
本综述纳入了一项有42名参与者的研究。结果表明，对于高危GTT，MAC方案因毒性较低而优于CHAMOCA方案。该研究的质量尚不清楚。
纳入研究的方法学局限性使得无法就高危GTT的最佳联合化疗方案得出任何确凿结论。需要高质量的研究。
