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对铂类药物有耐药性难治性绒癌的治疗很少有明确的方案,报道应用紫杉酚治疗2例对铂类耐药的绒癌的经验。 病例1.患者40岁,以突发的右上肢瘫痪入院,CT提示一肺门肿块、双肺多发结节影及肝脏转移。MRI示左额叶3处出血性病灶,肝活检为绒癌。查体子宫增大如10孕周,血hCG 7100ng/ml(正常值为2ng/ml)。给予全脑放疗2000cGy并EMACO化疗,方案:Act-D(0.5mg,iv)、Vp16(100mg/m~2,iv)、MTX(1g/m~2持续24h,iv)、VCR(1mg/m~2,iv)、CTX(600mg/m~2,iv),5疗程后hCG正常,又巩固治疗2疗程。hCG正常8月后,又升至16ng/ml,再予5疗
There are few clear protocols for the treatment of refractory platinum-resistant choriocarcinomas. The use of taxol in the treatment of platinum-resistant choriocarcinoma was reported in 2 patients. Case 1. The patient was 40 years old and admitted to the hospital with a sudden right upper limb paralysis. CT showed a hilar mass, multiple nodules in both lungs, and liver metastases. MRI showed three hemorrhagic lesions in the left frontal lobe. Liver biopsy was choriocarcinoma. Examination of the uterus enlargement such as 10 weeks of gestation, blood hCG 7100ng/ml (normal value 2ng/ml). Whole-brain radiotherapy 2000cGy and EMACO chemotherapy were given. Protocol: Act-D (0.5mg, iv), Vp16 (100mg/m~2, iv), MTX (1g/m~2 for 24h, iv), VCR (1mg/m) ~2,iv), CTX (600 mg/m~2,iv), normal hCG after 5 courses of treatment, and consolidation treatment 2 courses. After 8 months of normal hCG, it rose to 16 ng/ml again, and then to 5 treatments