Primary treatment of stage IV gestational trophoblastic neoplasia with floxuridine, dactinomycin, etoposide and vincristine (FAEV): A report based on our 10-year clinical experiences
Primary treatment of stage IV gestational trophoblastic neoplasia with floxuridine, dactinomycin, etoposide and vincristine (FAEV): A report based on our 10-year clinical experiences
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氟尿苷、放线菌素、依托泊苷和长春新碱 (FAEV) 对 IV 期妊娠滋养细胞肿瘤的初步治疗：基于我们 10 年临床经验的报告
DOI：
10.1016/j.ygyno.2016.07.099
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发表时间：
2016-10-01
影响因子：
4.7
通讯作者：
Ren, Tong
中科院分区：
文献类型：
--
作者：
Yang, Junjun;Xiang, Yang;Ren, Tong
客观的。评估氟尿苷、放线菌素、依托泊苷和长春新碱 (FAEV) 方案作为 IV 期妊娠滋养细胞肿瘤 (GTN) 主要治疗的疗效和毒性特征。方法。 2004年至2014年，北京协和医院对30例IV期GTN进行FAEV作为主要治疗（至少两个周期）。分析缓解/耐药/复发率、治疗失败的原因和毒性特征。结果。 30 名患者总共接受了 190 个周期的 FAEV；周期中位数为 6（范围 3-11）。中位随访时间为 52.3 个月（范围 8-120）。所有初次接受FAEV治疗的患者中，24例仅接受FAEV后获得完全缓解，无复发； 6 名患者后来因 FAEV 耐药而改用 EMACO 治疗。 6例患者中，2例经多线化疗后病情进展死亡，另4例经二线或三线化疗后达到完全缓解，其中1例15个月后复发。FAEV耐受性良好。没有人因中毒而死亡。 8 例 (26.7%) 和 2 例 (6.7%) 病例出现严重 4 级中性粒细胞减少症和血小板减少症。 8 至 120 个月的随访中未观察到继发性恶性肿瘤。接受 FAEV 治疗的患者显示出良好的生殖结果。结论。 FAEV方案可被视为IV期GTN主要治疗中其他化疗方案的替代方案，其缓解率高且毒性可耐受。 (C) 2016 年，爱思唯尔公司出版
Objective. To evaluate the efficacy and toxicity profile of floxuridine, dactinomycin, etoposide and vincristine (FAEV) regimen as primary treatment in stage IV gestational trophoblastic neoplasia (GTN).Methods. From 2004 to 2014, FAEV was given to 30 stage IV GTNs as the primary treatment (at least two cycles) in Peking Union Medical College Hospital. Remission/resistance/recurrence rate, the cause of treatment failure, and the toxicity profile were analyzed.Results. A total of 190 cycles of FAEV were administered to 30 patients; the median number of the cycles was 6 (range 3-11). The median follow up was 52.3 months (range 8-120). Of all the patients received FAEV primarily, 24 achieved complete remission after only received FAEV, with no recurrence; 6 patients later switched to EMACO treatment due to FAEV resistance. Among the 6 patients, 2 died of progressive disease after multiple lines of chemotherapy, the other 4 achieved complete remission after second-line or third-line chemotherapy and 1 of them relapsed 15 months later.FAEV was well tolerated. No one died from toxicity. Severe grade 4 neutropenia and thrombocytopenia were noted in 8 (26.7%) and 2 (6.7%) cases. No secondary malignancy was observed with follow-ups from 8 to 120 months. Patients treated with FAEV showed good reproductive outcomes.Conclusions. FAEV regimen might be considered as an alternative to other chemotherapy regimen in the primary treatment of stage IV GTN, where it had a high rate of remission and a tolerable toxicity. (C) 2016 Published by Elsevier Inc.