Soper J T, Hammond C B
Department of Obstetrics and Gynecology, Southeastern Trophoblastic Disease Center, Duke University Medical Center, Durham, NC 27710.
J Reprod Med. 1987 Sep;32(9):663-8.
Surgical procedures and radiotherapy continue to play a significant role in the management of gestational trophoblastic disease (GTD) despite continuing advances in chemotherapy. Suction curettage and hysterectomy are preferred techniques for evacuation of hydatidiform mole. Although primary chemotherapy alone is usually successful in women with nonmetastatic or good-prognosis metastatic GTD, hysterectomy is useful in selected patients to decrease the amount of chemotherapy required to produce remission or as salvage therapy in patients who have failed primary chemotherapy. Even among patients with poor-prognosis metastatic GTD, such adjunctive surgical procedures as hysterectomy, thoracotomy and craniotomy may be useful. Whole brain and liver irradiation is employed as adjuvant therapy to reduce hemorrhagic complications of brain and liver metastases.
尽管化疗不断取得进展，但手术和放疗在妊娠滋养细胞疾病（GTD）的治疗中仍发挥着重要作用。吸刮术和子宫切除术是清除葡萄胎的首选技术。虽然单纯的一线化疗通常对非转移性或预后良好的转移性GTD患者有效，但子宫切除术对部分患者有用，可减少达到缓解所需的化疗剂量，或作为一线化疗失败患者的挽救治疗。即使在预后不良的转移性GTD患者中，子宫切除术、开胸手术和开颅手术等辅助手术也可能有用。全脑和肝脏放疗用作辅助治疗，以减少脑和肝转移的出血并发症。
