摘要
目的探讨子宫切除术联合EMA-CO化疗方案治疗绝经后子宫绒毛膜癌(CC)的疗效,并分析其预后影响因素。方法将80例绝经后子宫CC患者按治疗方法不同分为对照组和观察组,每组40例,对照组给予子宫切除术治疗,观察组在对照组治疗基础上联合EMA-CO方案治疗。比较2组的临床疗效、治疗前后血清β-人绒毛膜促性腺激素(β-hCG)水平的变化、治疗期间不良反应发生情况,并分析其预后影响因素。结果2组治疗后血清β-hCG水平均较治疗前显著降低(P<0.05),且观察组降低较对照组改为显著(P<0.05)。观察组治疗总有效率显著高于对照组(80.0%比52.5%,P<0.05)。治疗期间观察组恶心呕吐、骨髓抑制、脱发、白细胞减少、口腔溃疡发生率显著均高于对照组(P<0.05)。绝经时间、国际妇产科联盟(FIGO)评分、治疗前血β-hCG水平与绝经后子宫绒癌患者预后相关(P<0.05)。结论子宫切除术联合EMA-CO化疗方案治疗绝经后子宫CC患者可获得较好的效果,绝经时间>10年、FIGO评分>11分、治疗前血清β-hCG水平>104 mU·mL^(-1)是绝经后子宫CC的预后影响因素。
Objective To investigate the efficacy of hysterectomy combined with the EMA-CO chemotherapy regimen in the treatment of postmenopausal uterine choriocarcinoma(CC)and analyze prognostic influencing factors.Methods 80 postmenopausal patients with uterine CC were allocated into a control group and an observation group(n=40 each)based on therapeutic approaches.The control group underwent hysterectomy,whereas the observation group received hysterectomy combined with the EMA-CO chemotherapy regimen.Comparative analyses were performed on clinical efficacy,pre-and post-treatment serumβ-human chorionic gonadotropin(β-hCG)levels,incidence of adverse reactions during treatment,and prognostic influencing factors between the 2 groups.Results Serumβ-hcg levels significantly decreased in both groups post-treatment compared to pretreatment values(P<0.05),with the observation group demonstrating a more pronounced reduction than the control group(P<0.05).The overall response rate was significantly higher in the observation group(80.0%vs.52.5%,P<0.05).The incidence rates of nausea and vomiting,myelosuppression,alopecia,leukopenia,and oral mucositis during treatment were significantly elevated in the observation group compared to the control group(P<0.05).Menopausal duration,FIGO score,and pre-treatment serumβ-hcg levels demonstrated statistically significant associations with the prognosis of postmenopausal patients with uterine CC(P<0.05).Conclusion Hysterectomy combined with the ema-co chemotherapy regimen may yield favorable therapeutic outcomes in postmenopausal patients with uterine cc,with menopausal duration>10 years,FIGO score>11,and pre-treatment serumβ-hCG levels>104 mU·mL^(-1) identified as prognostic influencing factors.
作者
闫谨
马晓明
李诗函
YAN Jin;MA Xiao-ming;LI Shi-han(Department of Gynecology,the First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,China)
出处
《实用临床医学(江西)》
2025年第2期69-74,共6页
Practical Clinical Medicine
