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首页> 外文期刊>Gynecology, obstetrics & reproductive medicine : >EMA/CO Combination Chemotheraphy in Gestational Trophoblastic Neoplasia: Update of Our Results
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EMA/CO Combination Chemotheraphy in Gestational Trophoblastic Neoplasia: Update of Our Results

机译：EMA / CO联合化学疗法治疗妊娠滋养细胞赘生物：我们的结果更新

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OBJECTIVE: In this study, we aimed updating our experience about the treatment success of EMA-CO (etoposide, methotrexate, actinomycin-D, cyclophosphamide, vincristine) chemotherapy in high-risk gestational trophoblastic neoplasia (GTN). MATERIAL AND METHOD: Patients were scored according to FIGO’s modified WHO system. Risk scoring of patients before 2000 was remade by using this system. Thirty-nine patients who were treated with EMA-CO between 1992 and 2013 because of high risk GTN or the resistance to single agent methotrexate and MAC III chemotherapy combinations were evaluated retrospectively. Adjuvant surgery and radiotherapy were used in selected patients. Response and effects of the prognostic factors to the response rate were analyzed. RESULTS: Median follow-up time of the patients was 74.8 months (range, 1-203). Complete clinical response was obtained in 36 (92.3%) patients with only EMA-CO or EMA-CO and surgery. The response rate of treatment was 91.3% (n:21/23) in patients taking primary EMA-CO, 93.8% (n:15/16) in patients taking secondary EMA/CO chemotherapy. Resistance to the EMA-CO treatment developed in 6 (15.3%) patients and 3 of the patients with drug resistance died. During the follow-up time disease recurred in 3 (7.7%) patients. When the antecedent pregnancy was term pregnancy or the histopathological diagnosis was choriocarcinoma or when there was liver metastasis, the treatment success decreased. The effects of tumor dimension and the presence of metastasis tended to be statistically significant in determining the resistance to therapy. CONCLUSION: EMA-CO regimen is highly effective for treatment of high-risk GTN. Because of the differences in many studies, risk factors for predicting the success of the treatment are not clear.
机译：目的：本研究旨在更新我们在高危妊娠滋养细胞赘生物（GTN）化疗中应用依托泊苷，甲氨蝶呤，放线菌素-D，环磷酰胺，长春新碱的成功经验。材料和方法：根据FIGO改良的WHO系统对患者进行评分。通过使用此系统，可以对2000年之前的患者进行风险评分。回顾性评估了1992年至2013年间因高危GTN或对单药甲氨蝶呤和MAC III化疗耐药性而接受EMA-CO治疗的39例患者。某些患者接受了辅助手术和放疗。分析了反应和预后因素对反应率的影响。结果：患者的中位随访时间为74.8个月（范围1-203）。仅使用EMA-CO或EMA-CO并接受手术的36例（92.3％）患者获得了完整的临床反应。接受初次EMA-CO的患者的治疗反应率为91.3％（n：21/23），接受二次EMA / CO化疗的患者的治疗反应率为93.8％（n：15/16）。在6（15.3％）位患者中出现了对EMA-CO治疗的耐药性，其中3名耐药性患者死亡。在随访期间，3例患者（7.7％）患病。前期妊娠为足月妊娠或组织病理学诊断为绒癌，或有肝转移时，治疗成功率降低。在确定对治疗的抵抗力方面，肿瘤的大小和转移的存在往往具有统计学意义。结论：EMA-CO方案对高危GTN的治疗非常有效。由于许多研究存在差异，因此尚不清楚用于预测治疗成功的危险因素。

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