Salvage combination chemotherapy with floxuridine, dactinomycin, etoposide, and vincristine (FAEV) for patients with relapsed/chemoresistant gestational trophoblastic neoplasia
Salvage combination chemotherapy with floxuridine, dactinomycin, etoposide, and vincristine (FAEV) for patients with relapsed/chemoresistant gestational trophoblastic neoplasia
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DOI：
10.1093/annonc/mdq649
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发表时间：
2011-07-01
影响因子：
50.5
通讯作者：
Wang, T.
中科院分区：
文献类型：
--
作者：
Feng, F.;Xiang, Y.;Wang, T.
背景资料：虽然大多数妊娠滋养细胞肿瘤（GTN）患者通过常规化疗治愈，但有些患者会产生耐药性或复发。已经研究了使用新的组合药物来治疗耐药或复发性疾病。我们评估的结果，阿替尿苷，更生霉素，依托泊苷，长春新碱（FAEV）化疗复发/耐药GTN患者。患者和方法：复发/耐药GTN患者的临床资料和结果从2005年1月1日至2008年6月30日进行了回顾性分析。符合条件的患者接受了至少一个周期的FAEV化疗。主要终点为FAEV方案的有效率和毒性反应，次要终点为临床疗效预测因素的评估。其中55例（60.4%）患者达到血清学完全缓解（SCR），29例患者无反应，7例患者出现≥ 3级复发或不可耐受的毒性。多因素分析显示，FAEV化疗的SCR与既往化疗方案数（< 2）显著相关（P = 0.005）。最严重的不良反应为≥ 3级中性粒细胞减少（26.4%）、发热性中性粒细胞减少（6.6%）和≥ 3级血小板减少（3.3%）。对该方案的进一步研究是必要的。
Background: Although most patients with gestational trophoblastic neoplasia (GTN) are cured by conventional chemotherapy, some develop drug resistance or relapse. The use of new combination drugs has been studied to treat those with resistant or relapsed disease. We evaluated the results of floxuridine, dactinomycin, etoposide, and vincristine (FAEV) chemotherapy in patients with relapsed/chemoresistant GTN.Patients and methods: Clinical data and outcome of the patients with relapsed/chemoresistant GTN from 1 January 2005 to 30 June 2008 were retrospectively reviewed. Eligible patients had received at least one cycle of FAEV chemotherapy. The primary end points were response rate and toxicity of FAEV regimen; the secondary end point was assessment of clinical predictors of response.Results: In total, 91 patients were included. Fifty-five of these patients (60.4%) achieved serologic complete remission (SCR), 29 patients had no response, 7 patients experienced recurrent grade >= 3 or intolerable toxicity. SCR of FAEV chemotherapy was significantly associated with number of previous chemotherapy regimens (< 2) in multivariate analysis (P = 0.005). The most serious adverse events were greater than or equal to grade 3 neutropenia (26.4%), febrile neutropenia (6.6%), and greater than or equal to grade 3 thrombocytopenia (3.3%).Conclusion: FAEV is an effective regimen with manageable toxicity for patients with relapsed/chemoresistant GTN. Further studies of this regimen are warranted.