Role of surgery and radiation therapy in the management of gestational trophoblastic disease
Role of surgery and radiation therapy in the management of gestational trophoblastic disease
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DOI：
10.1016/s1521-6934(03)00091-9
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发表时间：
2003-12-01
影响因子：
5.5
通讯作者：
Soper, JT
中科院分区：
文献类型：
--
作者：
Soper, JT
尽管敏感的人绒毛膜促性腺激素 (hCG) 检测和化疗的进展在妊娠滋养细胞疾病 (GTD) 的治疗中占据首要地位，但手术和放射治疗在患者的整体管理中仍然很重要。葡萄胎妊娠的管理包括手术清除和随后的监测。子宫切除术可以降低磨牙后滋养细胞疾病的风险。当子宫切除术纳入恶性 GTD 的主要治疗时，可以减少低风险疾病患者的化疗需求。经常需要手术干预来控制疾病的并发症或作为化疗期间稳定患者的治疗方法。挽救性子宫切除术或其他摘除手术可以纳入化疗难治性疾病患者的治疗中。介入放射照相技术是控制阴道或盆腔转移出血的有用辅助手段。放射治疗也可以与化疗相结合，用于治疗脑转移或其他部位孤立转移的患者（罕见）。
Although sensitive human chorionic gonadotrophin (hCG) assays and advances in chemotherapy have assumed primary importance in the management of gestational trophoblastic disease (GTD), surgery and radiation therapy remain important in the overall management of patients. Management of molar pregnancies consists of surgical evacuation and subsequent monitoring. Hysterectomy may decrease the risk of post-molar trophoblastic disease. When incorporated into the primary management of malignant GTD, hysterectomy decreases chemotherapy requirements for patients with low-risk disease. Surgical intervention is frequently required to control complications of disease or as therapy to stabilize patients during chemotherapy. Salvage hysterectomy or other extirpative procedures may be integrated into the management of patients with chemorefractory disease. Interventional radiographical techniques are useful adjuncts to control haemorrhage from vaginal or pelvic metastases. Radiation therapy may also be combined with chemotherapy for the management of patients with brain metastases or, rarely, isolated metastases at other sites.