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剖宫产瘢痕妊娠 1

子宫动脉栓塞术 1

清宫术 1

甲氨蝶呤 1

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Chemotherapy initiation with single-course methotrexate alone or combined with dactinomycin versus multi-coursemethotrexate for low-risk gestational trophoblastic neoplasia: a multi-centric randomized clinical trial

《医学前沿（英文）》 2022年第16卷第2期页码 276-284 doi: 10.1007/s11684-021-0855-4

摘要： We aimed to evaluate the effectiveness and safety of single-course initial regimens in patients with low-risk gestational trophoblastic neoplasia (GTN). In this trial (NCT01823315), 276 patients were analyzed. Patients were allocated to three initiated regimens: single-course methotrexate (MTX), single-course MTX+ dactinomycin (ACTD), and multi-course MTX (control arm). The primary endpoint was the complete remission (CR) rate by initial drug(s). The primary CR rate was 64.4% with multi-course MTX in the control arm. For the single-course MTX arm, the CR rate was 35.8% by one course; it increased to 59.3% after subsequent multi-course MTX, with non-inferiority to the control (difference –5.1%, 95% confidence interval (CI) –19.4% to 9.2%, P=0.014). After further treatment with multi-course ACTD, the CR rate (93.3%) was similar to that of the control (95.2%, P=0.577). For the single-course MTX+ACTD arm, the CR rate was 46.7% by one course, which increased to 89.1% after subsequent multi-course, with non-inferiority (difference 24.7%, 95% CI 12.8%–36.6%, P<0.001) to the control. It was similar to the CR rate by MTX and further ACTD in the control arm (89.1% vs. 95.2%, P=0.135). Four patients experienced recurrence, with no death, during the 2-year follow-up. We demonstrated that chemotherapy initiation with single-course MTX may be an alternative regimen for patients with low-risk GTN.

关键词： gestational trophoblastic neoplasia (GTN) methotrexate (MTX) dactinomycin (ACTD)

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子宫动脉灌注栓塞联合清宫术治疗子宫剖宫产瘢痕妊娠的效果评价

冯颖,李坚,陈素文,李长东,张晓峰,胡乔飞

《中国工程科学》 2014年第16卷第5期页码 4-10

摘要： 2003 年2 月至2010 年3 月35 例CSP患者采用甲氨蝶呤全身及局部注射（简称MTX组）联合清宫术治疗。MTX保守治疗组和UACE治疗组的患者年龄、剖宫产次、妊娠时间、孕囊直径及血清β人绒毛膜促性腺激素（β—HCG）之间，差异无统计学意义，但UACE治疗组在清宫术中出血量，血清β—HCG恢复正常的时间及住院时间上，要明显少于MTX保守治疗组，两组差异有统计学意义。

关键词：剖宫产瘢痕妊娠子宫动脉栓塞术甲氨蝶呤清宫术