Soper J T, Evans A C, Rodriguez G, Berchuck A, Clarke-Pearson D L, Hammond C B
Division of Gynecologic Oncology, Duke University Medical Center, Durham, North Carolina 27710, USA.
Gynecol Oncol. 1995 Mar;56(3):421-4. doi: 10.1006/gyno.1995.1074.
The purpose of this study was to determine activity of etoposide-platin combination chemotherapy for chemorefractory gestational trophoblastic disease. A retrospective review of patients treated with etoposide-platin chemotherapy for chemorefractory trophoblastic disease was conducted. Patients received etoposide 100 mg/m2 and cisplatin 20 mg/m2 on Days 1 through 5 of 14- to 21-day cycles. Patient characteristics, responses, and toxicity were recorded. Seven women received etoposide-platin for chemorefractory disease. The median WHO prognostic index score upon initiation of therapy was 16 (range, 10-20) and patients had received a median 6 cycles of prior combination chemotherapy. Five patients developed grade IV neutropenia, four developed neutropenic sepsis, and two required platelet transfusions. Two patients developed significant deterioration of renal function. Six (86%) patients had complete responses, with normalization of hCG values, but only three (43%) patients with low pretherapy hCG levels have had sustained remissions. Etoposide-platin chemotherapy is an active regimen for the treatment of women with chemorefractory gestational trophoblastic disease but has significant hematologic and renal toxicity when used as salvage therapy. Future studies should investigate the incorporation of etoposide-platin into initial therapy of women with high-risk disease.
本研究的目的是确定依托泊苷 - 铂联合化疗对化疗难治性妊娠滋养细胞疾病的疗效。对接受依托泊苷 - 铂化疗治疗化疗难治性滋养细胞疾病的患者进行了回顾性研究。患者在14至21天周期的第1至5天接受依托泊苷100mg/m²和顺铂20mg/m²治疗。记录患者特征、反应和毒性。7名女性接受依托泊苷 - 铂治疗化疗难治性疾病。开始治疗时WHO预后指数评分中位数为16（范围10 - 20），患者此前接受联合化疗的中位数为6个周期。5名患者出现IV级中性粒细胞减少，4名发生中性粒细胞减少性败血症，2名需要输注血小板。2名患者出现肾功能显著恶化。6名（86%）患者完全缓解，hCG值恢复正常，但只有3名（43%）治疗前hCG水平低的患者持续缓解。依托泊苷 - 铂化疗是治疗化疗难治性妊娠滋养细胞疾病女性的一种有效方案，但用作挽救治疗时具有显著的血液学和肾脏毒性。未来研究应探讨将依托泊苷 - 铂纳入高危疾病女性的初始治疗。
