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超大剂量化学药物和外周血干细胞移植治疗晚期妇科恶性肿瘤5例分析 |
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黄惠芳 黄荣丽 潘凌亚 沈铿 吴鸣 郎景和 沈悌 焦力
【摘要】 目的 探讨超大剂量化学药物和外周血干细胞移植治疗晚期妇科恶性肿瘤的临床疗效。方法 对4例卵巢癌，1例输卵管癌，在肿瘤基本切净后行超大剂量化学治疗（HDC）及外周血干细胞移植术（PBSCT）(其中4例为复发病例,1例为初治Ⅲ期卵巢癌)，观察疗效及副反应发生情况。结果 5例患者接受HDC和PBSCT治疗后，4例临床缓解，1例卵巢幼年型颗粒细胞瘤疾病进展死亡。4例患者临床无瘤缓解期平均为9个月；平均存活时间21个月。超HDC治疗副反应主要为骨髓严重抑制，外周血白细胞最低降到0.05×109/L～0.2×109/L；血小板降到7×109/L～8×109/L；粒细胞恢复到>0.5×109/L的时间平均为14 d；血小板恢复到50×109/L的时间平均为17 d。5例患者无一例出现其他的严重并发症。结论 超HDC和PBSCT治疗晚期卵巢癌，虽副反应较严重，但严格掌握病例选择标准，还是安全、可行的。对于耐药复发病例的疗效，还有待于进一步观察。
【关键词】 药物疗法； 造血干细胞移植；卵巢肿瘤
High-dose Chemotherapy with Peripheral-blood Stem Cells Transplantation in Patients with Advanced Gynecological Malignant Tumors
HUANG Huifang， HUANG Rongli，PAN Lingya, et al.
（Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China）
【Abstract】 Objective To evaluate the clinical effectiveness of high dose chemotherapy（HDC）with peripheral -blood stem cells transplantation（PBSCT）in the patients with advanced malignant tumors. Methods Four patients with advanced or refractory ovarian carcinoma and 1 patient with recurrent fallopian tube carcinoma received the HDC with PBSCT after optimal tumor debulking. Of whom 4 patients were with the recurrent or progressive tumors，1 patient received HDC as primary chemotherapy. The response and toxicity were assessed after treatment. Results Among 5 patients， four patients are survival. One case died from the recurrence of juvenile granulosa cell tumor. The average survival periods were 21 months. The tumors were all recurrent among the 4 survival patients. The average periods of recurrence after HDC treatment was 9 months. The main toxicity of HDC was severe marrow suppression. The lowest value of the neutrophil count and platelet count was 0.05-0.2×109/L and 7×109/L～8×109/L respectively. The median time to recover a neutrophil count greater[1] [2] [3] 下一页
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