Tham K F, Ratnam S S
Department of Obstetrics and Gynecology, National University of Singapore, National University Hospital, Ridge, Singapore.
Int J Gynaecol Obstet. 1995 Jul;49 Suppl:S77-89. doi: 10.1016/0020-7292(95)02413-7.
Gestational trophoblastic disease has been recognized as a form of abnormal pregnancy as early as 1600 AD, and choriocarcinoma was the first cancer to be cured with chemotherapy even in the presence of distant and widespread metastases. Important advances in the past include the standardization of terminology, the concept of assignment of risk and the use of staging systems, the centralization of care and the establishment of regional registries, and of course the development of the radioimmunoassay for the beta subunit of human chorionic gonadotropin. The current views on the management of this disease recognizes the need for a multidisciplinary approach, with chemotherapy remaining at the forefront but also utilizing newer diagnostic techniques when necessary, and keeping in mind the crucial role that surgery can play especially in resistant cases. At the same time, the importance of basics such as careful follow up after evacuation of a hydatidiform mole cannot be overemphasized. There will be a continual refinement of the chemotherapy regimes used, and the aim is to achieve a similar level of response with decreased toxicity to the patient.
早在公元1600年，妊娠滋养细胞疾病就已被确认为一种异常妊娠形式，绒毛膜癌是第一种即使在存在远处广泛转移的情况下也能通过化疗治愈的癌症。过去的重要进展包括术语标准化、风险评估概念和分期系统的使用、护理集中化和区域登记处的建立，当然还有人绒毛膜促性腺激素β亚基放射免疫测定法的发展。目前对这种疾病管理的观点认识到需要多学科方法，化疗仍然处于前沿，但必要时也利用更新的诊断技术，并牢记手术尤其在耐药病例中可以发挥的关键作用。与此同时，葡萄胎排空后仔细随访等基础工作的重要性再怎么强调也不为过。所使用的化疗方案将不断完善，目标是在降低对患者毒性的情况下实现相似的反应水平。
