恶性妊娠滋养细胞疾病的治疗失败

Treatment failure in malignant gestational trophoblastic disease.

作者信息

Byun J S, Yoon Y D, Oh S T, Song T B, Choi H S, Lee Y I

机构信息

Department of Obstetrics and Gynecology, Chonnam National University Medical School, Kwangju, Korea.

出版信息

Asia Oceania J Obstet Gynaecol. 1993 Sep;19(3):277-83. doi: 10.1111/j.1447-0756.1993.tb00386.x.

DOI:10.1111/j.1447-0756.1993.tb00386.x

PMID:8250762

Abstract

One hundred and thirty-three patients with malignant gestational trophoblastic disease (GTD) were admitted. All patients (86/86) of the nonmetastatic and metastatic low-risk groups and 89.4% (42/47) of the metastatic high-risk group showed remission. The overall remission rate was 96.2%. Among 5 patients with brain metastases, however, only one (20%) survived. We arrived at two main conclusions. First, brain metastatic lesions did not successfully respond to therapy utilizing conventional chemotherapeutic regimens. Second, the key factors for successful outcome in brain metastases were early diagnosis and aggressive initial therapy. Therefore, early detection of brain metastases should be made with: (1) fine computerized tomography (CT) or magnetic resonance imaging (MRI), (2) measurement of the ratio of serum to cerebrospinal fluid hCG concentration, and (3) early recognition of their clinical features.

摘要

收治了133例恶性妊娠滋养细胞疾病（GTD）患者。非转移性和低危转移性组的所有患者（86/86）以及高危转移性组的89.4%（42/47）患者病情缓解。总缓解率为96.2%。然而，在5例脑转移患者中，仅1例（20%）存活。我们得出两个主要结论。第一，脑转移病灶对采用传统化疗方案的治疗没有成功反应。第二，脑转移成功治疗的关键因素是早期诊断和积极的初始治疗。因此，应通过以下方法早期发现脑转移：（1）精细计算机断层扫描（CT）或磁共振成像（MRI），（2）测量血清与脑脊液人绒毛膜促性腺激素（hCG）浓度比值，以及（3）早期识别其临床特征。