The prognosis of gestational trophoblastic neoplasia patient with residual lung tumor after completing treatment
The prognosis of gestational trophoblastic neoplasia patient with residual lung tumor after completing treatment
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DOI：
10.1016/j.ygyno.2006.03.015
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发表时间：
2006-11-01
影响因子：
4.7
通讯作者：
Yang, Xiuyu
中科院分区：
文献类型：
--
作者：
Yang, Junjun;Xiang, Yang;Yang, Xiuyu
目标。回顾性分析妊娠滋养细胞瘤（GTN）患者在完成治疗后β - hcg滴度正常但仍残留肺肿瘤的预后。1985年1月至2004年1月北京协和医院共收治GTN患者1130例。在这些患者中，901例达到完全缓解（CR）；152例患者在治疗结束后血液β - hcg滴度正常，但仍有残余肺肿瘤（定义为部分缓解）。对152例患者进行回顾性分析。采用统计学方法对152例CR患者的复发率与进展率进行比较。152例患者中有17例失去随访。其余135例患者随访14至110个月，其中83例肿瘤残留无明显变化；残余肿瘤缩小或消失46例；其余6例出现疾病进展（PD），治疗结束后6 ~ 8个月β - hcg水平升高。901例CR患者的复发率与152例CR患者的进展率比较，差异无统计学意义（P < 0.05）。CR合并肺转移患者的复发率与152例患者的进展率比较，差异无统计学意义（P < 0.05）。在β - hcg滴度达到正常后，即使再进行几次化疗，肺肿瘤仍未发生变化的患者应视为CR患者。这些患者应严格随访，特别是在治疗完成后6个月左右，特别是对高危和耐药绒毛膜癌（CC）患者。(c) 2006爱思唯尔公司版权所有。
Objective. To analyze retrospectively the prognosis of gestational trophoblastic neoplasia (GTN) patients who achieved normal beta-hCG titer after completing treatment but remained with residual lung tumor.Method. A total of 1130 GTN patients were hospitalized at Peking Union Medical College Hospital from January 1985 to January 2004. Among these patients, 901 achieved complete remission (CR); 152 achieved normal blood beta-hCG titer after the completion of treatment but remained with residual lung tumor (defined as partial remission). Retrospective analyses were carried out on the 152 patients. Statistical analysis was used to compare the recurrent rate of the CR patients with the progression rate of the 152 patients.Result. 17 of the 152 patients lost follow-up. Of the rest 135 patients followed up from 14 to 110 months, 83 showed no significant changes as to their residual tumors; 46 patients' residual tumors diminished or disappeared; and the other 6 patients got progression of disease (PD), with beta-hCG level going up 6-8 months after completing treatment. There is no significant statistical difference (P > 0.05) between the recurrent rate of the 901 CR patients and the progression rate of the 152 patients. There is also no significant statistical difference (P > 0.05) between the recurrent rate of the CR patients with lung metastasis and the progression rate of the 152 patients.Conclusion. After achieving normal beta-hCG titer, patients whose lung tumor stayed unchanged even following several additional courses of chemotherapy should be considered as CR patients. Follow-ups should be strictly carried out on these patients, especially at around 6 months after the completion of treatment, and particularly for high-risk and drug-resistant choriocarcinoma (CC) patients. (c) 2006 Elsevier Inc. All rights reserved.