Department of Medical Oncology, Cancer Institute, Adyar, India.
Int J Gynaecol Obstet. 2011 Oct;115(1):37-9. doi: 10.1016/j.ijgo.2011.04.017. Epub 2011 Jul 29.
To evaluate the efficacy of etoposide, cisplatin-etoposide, methotrexate, actinomycin-D (EP-EMA) chemotherapy as the frontline treatment for gestational trophoblastic neoplasia (GTN) patients with very high (≥ 12) FIGO prognostic scores.
Nine patients with very-high-risk GTN were treated with EP-EMA at the Cancer Institute, Adyar, India, between January 1, 2001, and December 31, 2007. Salvage chemotherapy, adjuvant surgery, and radiotherapy were used when indicated. Clinical response, toxicity, and survival were analyzed separately.
The median FIGO score was 15. Six (66.7%) patients had a complete clinical response, whereas progressive disease occurred for 3 (33.3%) women. None of the patients relapsed. This translated to an overall survival rate of 66.7% in the primary setting. All patients with liver-only metastases were survivors after treatment with EP-EMA. Grade 3 neutropenia was detected in 3 (33.3%) patients only. No life-threatening toxicity was observed after EP-EMA treatment.
EP-EMA was highly effective for the primary management of very-high-risk GTN.
评估依托泊苷、顺铂-依托泊苷、甲氨蝶呤、放线菌素 D（EP-EMA）化疗作为 FIGO 预后评分非常高（≥12）的妊娠滋养细胞肿瘤（GTN）患者一线治疗的疗效。
2001 年 1 月 1 日至 2007 年 12 月 31 日，印度 Adyar 癌症研究所对 9 例非常高危 GTN 患者采用 EP-EMA 治疗。根据需要进行挽救化疗、辅助手术和放疗。分别分析临床反应、毒性和生存情况。
FIGO 评分中位数为 15。6 例（66.7%）患者完全临床缓解，而 3 例（33.3%）患者病情进展。无患者复发。这在原发性疾病中转化为 66.7%的总生存率。所有仅肝转移的患者在接受 EP-EMA 治疗后均存活。仅 3 例（33.3%）患者出现 3 级中性粒细胞减少症。EP-EMA 治疗后未观察到危及生命的毒性。
EP-EMA 对非常高危 GTN 的一线治疗非常有效。
