DuBeshter B, Berkowitz R S, Goldstein D P, Bernstein M
Department of Obstetrics and Gynecology, Brigham & Women's Hospital, Boston, MA 02115.
J Reprod Med. 1989 Mar;34(3):189-92.
Vinblastine, cisplatin and bleomycin (VPB) were utilized as salvage therapy in seven women with high-risk metastatic gestational trophoblastic tumors resistant to prior treatment with triple therapy (methotrexate, actinomycin D and cyclophosphamide) or the modified Bagshawe protocol. While four patients (57%) achieved sustained remission with VPB, surgery was performed on two of them to remove sites of resistant disease. The mean prognostic score for the patients who achieved remission was 10 versus 17 for those who died (P less than .05). Although severe hematologic toxicity occurred in five patients (71%), no deaths were attributable to toxicity. Since VPB has limited activity when used as salvage therapy, alternate chemotherapy protocols need to be developed for patients with refractory gestational trophoblastic disease.
长春碱、顺铂和博来霉素（VPB）被用作挽救疗法，用于治疗7名患有高危转移性妊娠滋养细胞肿瘤的女性，这些患者对先前的三联疗法（甲氨蝶呤、放线菌素D和环磷酰胺）或改良的巴格肖方案治疗耐药。虽然4名患者（57%）通过VPB实现了持续缓解，但其中2名患者接受了手术以切除耐药病灶部位。实现缓解的患者的平均预后评分为10分，而死亡患者为17分（P小于0.05）。虽然5名患者（71%）发生了严重血液学毒性，但无死亡归因于毒性。由于VPB用作挽救疗法时活性有限，需要为难治性妊娠滋养细胞疾病患者制定替代化疗方案。
