Advances in management of high-risk gestational trophoblastic tumors.

摘要: Multimodality therapy with combination chemotherapy employing etoposide, high-dose methotrexate, actinomycin D, cyclophosphamide and vincristine adjuvant radiotherapy surgery, when indicated, has resulted in cure rates of 80-90% patients high-risk metastatic gestational trophoblastic tumors. However, 25-30% will have an incomplete response to first-line or relapse from remission. Most these a clinicopathologic diagnosis choriocarcinoma, multiple metastases sites other than the lung vagina, failed inappropriate previous chemotherapy, resulting very high World Health Organization scores. Salvage cisplatin/etoposide, usually conjunction bleomycin ifosfamide, as well surgical resection resistant disease selected patients, result for most patients. Colony-stimulating factors should be used prevent treatment delays dose reductions. Newer anticancer agents, such paclitaxel gemcitibine, without autologous bone marrow transplantation peripheral blood stem cell support may play role future management