Comparison of 5-day MTX and 5-day ETP treatment results and early predictors of drug resistance to 5-day MTX in patients with post-molar low-risk gestational trophoblastic neoplasia
Comparison of 5-day MTX and 5-day ETP treatment results and early predictors of drug resistance to 5-day MTX in patients with post-molar low-risk gestational trophoblastic neoplasia
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DOI：
10.1016/j.ygyno.2015.10.007
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发表时间：
2015-12-01
影响因子：
4.7
通讯作者：
Shozu, Makio
中科院分区：
文献类型：
--
作者：
Kizaki, Shoko;Hashimoto, Kazunori;Shozu, Makio
客观的。旨在确定接受 5 天肌肉注射甲氨蝶呤 (5 天 IM MTX) 或 5 天滴注依托泊苷 (5 天 DIV ETP) 方案治疗的磨牙后低危妊娠滋养细胞肿瘤 (GTN) 患者的主要缓解率和耐药预测因素。方法。 1980 年至 2014 年间，连续 166 名低风险磨牙后 GTN 患者最初接受了 5 天 IM MTX 或 5 天 DIV ETP 方案治疗。比较初次缓解率、耐药或毒性引起的化疗变化以及复发率。此外，我们分析了影响 MTX 耐药性发展的因素。结果。 ETP 治疗患者的初次缓解率显着高于 MTX 治疗患者。在42名需要改变化疗的患者中，分别有23名患者（22.6%）和4名患者（6.3%）被诊断为对MTX和EPT耐药。母亲年龄和转移的存在并没有显着影响 MTX 耐药的发生，尽管较高的 FIFAO 评分和治疗前人绒毛膜促性腺激素 (hCG) 水平 > 5 x 10(4) mIU/mL 在发生 MTX 耐药的患者中更为常见。此外，一个
Objective. To determine the primary remission rates and predictors of drug resistance in patients with post-molar low-risk gestational trophoblastic neoplasia (GTN) who were treated with a 5-day intramuscular methotrexate (5-day IM MTX) or a 5-day drip infusion etoposide (5-day DIV ETP) regimen.Methods. Between 1980 and 2014, 166 consecutive patients with low-risk post-molar GTN were initially treated with a 5-day IM MTX or a 5-day DIV ETP regimen. The primary remission rates, changes in chemotherapy due to drug resistance or toxicity, and relapse rates were compared. Furthermore, we analyzed the factors that influenced the development of resistance to MTX.Results. Primary remission rates were significantly higher among the ETP-treated patients than among the MTX-treated patients. Among the 42 patients who required a change in chemotherapy, 23 patients (22.6%) and 4 patients (6.3%) were diagnosed as being resistant to MTX and EPT, respectively. Maternal age and the presence of metastasis did not significantly influence the development of MTX resistance, although higher FIGO scores and pre-treatment human chorionic gonadotropin (hCG) levels of >5 x 10(4) mIU/mL were significantly more common among patients who developed MTX resistance. Moreover, a