MAC与EMA-CO方案治疗妊娠滋养细胞肿瘤肺转移的疗效对比分析

目的:对比评价两方案（MAC方案与EMA-CO方案）治疗妊娠滋养细胞肿瘤肺转移的疗效和毒副反应,以期为妊娠滋养细胞肿瘤肺转移化疗提供借鉴。方法:选择2009年6月至2013年12月的妊娠滋养细胞肿瘤肺转移患者124例作为研究对象，采用随机数字表法将其随机分为两组:治疗组和对照组，对照组予以EMA-CO方案治疗，治疗组MAC方案治疗，观察其疗效和副反应评价。结果:MAC方案组与EMA-CO方案组治疗妊娠滋养细胞肿瘤肺转移的完全缓解率分别为76.67%和71.88%,有效率分别为96.67%和100%；完全缓解率及有效率的比较经χ2检验，P＞0.05，差异无显著性意义，MAC方案低危型CR率明显高于EMA-CO方案，高危型CR率低于EMA-CO方案，组间比较差异均有统计学意义；MAC方案组血HCG降至正常时间及总疗程均较EMA-CO方案组少。两组患者恶心呕吐发生率、肝肾损伤发生率比较，P＞0.05,在统计学上无明显差异；但MAC组的骨髓抑制发生率和肝肾损伤发生率、严重程度及腹泻发生率、口腔溃疡发生率均低于EMA-CO组，P均<0.05,差异有统计学意义。另外，MAC方案组的复发率、平均住院日、化疗时间、费用等指标均较EMA-CO方案组少。结论:采用MAC方案治疗妊娠滋养细胞肿瘤肺转移的总体疗效与EMA-CO方案相当，MAC组重度骨髓抑制、胃肠道反应及口腔溃疡的发生明显少于EMA-CO组,并且疗程短,化疗时间及费用少,复发率低,患者更易于接受,依从性好,可以作为临床一线用药进一步推广。

Clinical research gestational trophoblastic tumor lung metastases

Objective:comparative two treatments of gestational trophoblastic efficacy and toxicity with tumor lung metastases. Methods:All 124 patients with lung metastases were randomly divided into two groups,the treatment group and the control group. The control group was given EMA - CO regimen,the treatment group MAC regimen. Re-sults:MAC program group and EMA - CO regimen treatment of gestational trophoblastic tumor complete response rate of pulmonary metastasis were 76. 67% and 71. 88% ,effective rate was 96. 67% and 100% ,respectively. P > 0. 05, the difference was not statistically significant in two groups. FIGO prognostic score low risk and high - risk CR rate and CR + PR rate differences were statistically significant,MAC scheme CR rate was significantly low risk higher than EMA - CO program,high - risk CR rate lower than EMA - CO program,there were significant differences be-tween the groups. Two groups of patients the incidence of nausea and vomiting,the incidence of liver and kidney dam-age,P > 0. 05,no statistically significant difference. MAC croup marrow suppression and kidney injury incidence rate and severity,the incidence of diarrhea,mouth ulcers were lower than EMA - CO group,P < 0. 05. Conclusion:MAC regimen gestational trophoblastic tumor lung metastases overall efficacy and EMA - CO program fairly,MAC group and severe bone marrow suppression,gastrointestinal reactions and oral ulcers was significantly less than the EMA - CO group,and short course chemotherapy time and cost less,recurrence rate.