Manopunya Manatsawee, Suprasert Prapaporn
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Asian Pac J Cancer Prev. 2012;13(1):387-90. doi: 10.7314/apjcp.2012.13.1.387.
A combination of 5-fluorouracil plus actinomycin D (5FU plus Act D) is the regimen that has been commonly administered to Chinese and Japanese gestational trophoblastic neoplasia patients as the first or second line of treatment with an excellent outcome. However, the efficacy of this regimen in a salvage setting was unclear. To evaluate the efficacy and safety of the 5 FU plus Act D regimen utilized in this condition, all GTN patients resistant to at least three previous chemotherapy regimens who received the 5 FU plus Act D regimen between August 2009 and January 2011 at Chiang Mai University Hospital were reviewed. There were five cases who met the criteria. Four of those patients were in FIGO stage III to IV with a WHO scoring of more than 12. The median number of cycles for each patient was two and only one case achieved remission while four of the cases were unresponsive. The toxicity was evaluated in 12 cycles. Common complications were uncomplicated myelosuppression and mucositis. In conclusion, this regimen revealed modest efficacy in a salvage setting with manageable toxicity.
5-氟尿嘧啶联合放线菌素D（5FU联合Act D）方案一直是中国和日本妊娠滋养细胞肿瘤患者常用的一线或二线治疗方案，疗效良好。然而，该方案在挽救性治疗中的疗效尚不清楚。为了评估5FU联合Act D方案在此种情况下的疗效和安全性，我们回顾了2009年8月至2011年1月期间在清迈大学医院接受5FU联合Act D方案治疗、对至少三种先前化疗方案耐药的所有妊娠滋养细胞肿瘤（GTN）患者。有5例患者符合标准。其中4例患者为FIGO III至IV期，WHO评分超过12分。每位患者的中位化疗周期数为2个，只有1例患者达到缓解，4例患者无反应。在12个周期中评估了毒性。常见并发症为无并发症的骨髓抑制和粘膜炎。总之，该方案在挽救性治疗中显示出一定疗效，毒性可控。
