| Objective Through retrospective analysis of the initial treatment of gestational trophoblastic neoplasia(GTN)patients with "5-FU + KSM" dual drug chemotherapy efficacy,to explore the feasibility of its as a first-line chemotherapy program.Method 1.Retrospective analysis of the clinical data of GTN patients in our hospital from January 2005 to December 2018,statistics of the clinical stages of GTN patients and the score of GTN patients according to FIGO(2000)prognosis scoring system;2.The complete and partial remission rates of GTN patients were statistically analyzed;3.To compare the effect of initial chemotherapy with 5-FU + KSM in patients with invasive hydatidiform mole(IM)and choriocarcinoma(CC);4.Through statistical analysis,the curative effect,chemotherapy course and side effects of single drug chemotherapy and 5-FU + KSM combined chemotherapy were compared;5.Single factor analysis of the factors that influence the therapeutic effect of GTN patients with initial treatment by "5-FU + KSM" chemotherapy;6.Follow up the pregnancy.Result Among 48 GTN patients,17 were in stage I,31 in stage III,46 in low-risk group and 2 in high-risk group.2.The serological complete remission rate(CR)was 95.83% and the partial remission rate(PR)was 4.17%.The CR rate of low-risk GTN patients and high-risk GTN patients were 95.65% and 100%,respectively.3.The CR rate of invasive hydatidiform mole(IM)and choriocarcinoma(CC)were 97.37% and 90%,respectively.There was no significant difference between them(P > 0.05).IM and CC had higher CR rate.4."5-FU + KSM" combined chemotherapy has no significant difference in the initial treatment of GTN compared with the single drug group(P > 0.05).The incidence of hair loss,myelosuppression and diarrhea in the former group is higher than that in the single drug chemotherapy,but the number of courses of turning negative and the total chemotherapy course are less than that in the single drug group.5.The level of h CG in blood before chemotherapy,the time from the termination of pregnancy to the beginning of chemotherapy,the nature of the last pregnancy,and the age in FIGO 2000 prognostic scoring system could not affect the chemotherapy effect of "5-FU + KSM".Single factor analysis of the above factors is not a risk factor for the effect of chemotherapy.6.During the follow-up period of 12-144 months,48 cases had no recurrence,and all of them survived up to now.One of them was pregnant and delivered,and the newborn was healthy.Conclusion 1."5-FU + KSM" combination scheme has certain advantages over single drug group,which can shorten the chemotherapy time and reduce the cost of patients;the side effects are less,the incidence of which is higher than that of single drug group,which is controllable and predictable;2.GTN patients with different characteristics(such as whether the last pregnancy is hydatidiform mole,different age,the level of h CG in blood before chemotherapy,the time between termination of pregnancy and the beginning of chemotherapy)can try out the program,which can achieve a higher serologic remission rate,and our hospital can take it as a first-line treatment program;3.When GTN patients choose chemotherapy plan,they should strictly observe the adverse reactions of drugs according to the principle of individualization,advocate symptomatic support treatment,improve the tolerance of patients,regularly follow up,strictly adjust the dosage of chemotherapy drugs according to the weight change,so as to obtain satisfactory curative effect;4.After chemotherapy,most of the patients are worried about the psychological disorder of pregnancy due to the recurrence of the disease.We should pay attention to the psychological state of the patients during the treatment,and try to relieve the patients’ worries. |
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