Clinical application of interventional therapy in the treatment of gestational trophoblastic neoplasia
10.3969/j.issn.1002-1671.2018.01.026
- VernacularTitle:介入治疗在妊娠滋养细胞肿瘤治疗中的临床应用
- Author:
Jianhao ZHANG
1
;
Xinwei HAN
;
Zongming LI
;
Zhenhua HU
;
Ying ZHANG
;
Ruixia GUO
;
Liuxia LI
Author Information
1. 郑州大学第一附属医院介入科
- Keywords:
gestational trophoblastic neoplasia;
interventional treatment;
chemotherapy;
embolism
- From:
Journal of Practical Radiology
2018;34(1):94-97
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect and clinical value of interventional therapy in the treatment of gestational trophoblastic neoplasia(GTN).Methods 28 cases of GTN were selected,of which 18 cases were treated with fluorouracil +dactinomycin(5-Fu+KSM)for 2 courses,however,the level of β-HCG and uterine lesions did not significantly reduced.The remained 10 cases were treated with etoposide+actinomycin-D+ methotrexate+ tetrahydrofolate+ vincristine+ cyclophosphamide(EMA-CO)chemotherapy for 2 courses,Ⅳ degree of myelosuppression and severe gastrointestinal reactions appeared and had to cease the next cycle of treatment. All patients were treated with uterine artery and/or ovarian arterial infusion(cisplatin,etoposide,bleomycin)for 2 courses,meanwhile, the gelatin sponge particles were used for embolization of uterine arteries and/or ovarian arteries.The β-HCG level,tumor volume, and the changes of sex hormones were tested before and one year after interventional therapy.Results 28 patients underwent transcatheter uterine arterial and/or ovarian arterial chemoembolization and embolization,the internal iliac arteriography showed significant tumor staining.20 patients underwent double uterine arterial infusion and embolization,and 8 patients underwent bilateral uterine arterial and unilateral ovarian arterial infusion and embolization.β-HCG and lesion size were measured on the 18th day after intervention.The results showed that the β-HCG decreased significantly after 2 courses of treatment,and the uterine lesion was reduced or disappeared,with a significant statistical difference,however,sex hormone levels did not changed significantly before interventional therapy and during one year follow-up.Conclusion The interventional treatment of GTN is less invasive,effective,and worthy of clinical application.
