Network Meta Analysis Of Drug Resistance In The First Single Drug Chemotherapy Of Low Risk Gestational Trophoblastic Neoplasia

Background:Gestational trophoblastic neoplasia(GTN)is a highly malignant gynecologic tumor,but it is also one of the best malignant tumors(1).At present,the principle of treatment is chemotherapy,surgery and radiotherapy are supplemented.Comprehensive score according to the clinical staging and prognosis of 2000 issued by the FIGO scoring system for low risk GTN used single drug chemotherapy,however,the current study shows that the resistance occurred about 10%to 67%of patients after chemotherapy(2-4).Objective:The article has systematically evaluate the drug resistance of the first single-drug regimen of low-risk GTN patients.Materials and methods:1.retrieval strategy:using computer retrieval as the main method,systematic retrieval Pubmed,Cochrane Library,Western biomedical journal literature database(FMJS),Chinese biomedical literature database(CBM),Chinese knowledge network(CNKI),Wanfang database,and artificial retrieval of relevant magazines,academic reports,references and phases Close the meeting record and so on.2.inclusion criteria:collect all randomized controlled trials of all low-risk GTN patients treated with single chemotherapy.The language is limited to Chinese and English.The retrieval time is limited to the literature from January 2000 to December 2017.3.data collection and analysis:the author independently completes data collection and quality assessment.The Bayesian network model of ADDIS software was used for mesh Meta analysis.4.main outcome evaluation:(1)efficacy evaluation:the complete remission rate,drug resistance rate and failure rate of chemotherapy(i.e.the incidence of rechemotherapy).(2)safety index:the incidence of side effects of chemotherapy.Results:a total of 7 randomized controlled clinical trials(RCT)were included,all in English,a total of 599 patients.Reticular Meta analysis showed that W-MTX(RR=5.82,95%CI:1.53?29.50),clinical remission rate(RR= 0.20,95%CI:0.05?0.70)were compared with the group of bi-ACT(each 2 weeks given with actinomycin-D1.25mg/m2 intravenously)in the group of methotrexate 30mg/m2 muscle injection each week,indicating that bi-Act was compared with W-MTX.It has obvious advantages.There were no statistical differences in other schemes.Conclusion:for the comparison of the regimen of the first single drug chemotherapy for the low risk GTN,it seems that Act-D every 2 weeks is the most ideal for the drug resistance and the rate of clinical remission?Objective:To compare of single-agent chemotherapy treatment of low-risk gestational trophoplastic neoplasia with combination—agent and the analysis of factors for developing drug resistance.Materials and methods:A retrospective analysis was made of 69 patients with low risk trophoblastic tumor in our hospital from January 2010 to December 2016,and divided into two groups according to the treatment scheme,namely,5-fluorouracil(5-FU)group,5-fluorouracil(5-FU)+ actinomycin-D(Act-D)group.The side effects of chemotherapy,the cure rate and the follow-up fertility of the two groups were compared?Results:1?the remission rate of team 5-FU regimen and team 5-FU?Act-D regimen was 76.6%and 86.3%respectively.The difference was not statistically significant(P>0.05).2?The drug resistance rate of the team 5-Fu regimen was 19.10%(9/47),and the drug resistance rate in the team 5-FU?Act-D was 9.09%(2/22).The difference was not statistically significant(P>0.05).3?However,it can be seen from the data analysis that the drug resistance rate of the team 5-FU?Act-D was low and the prognosis of the patients with the prognostic score was 4-6,and the chemotherapy regimens were mainly changed in 11 patients.The efficiency is 100%.4?There was no statistically significant difference in the incidence of side effects of chemotherapy in the two groups(P>0.05).Conclusion:1.There was no significant difference in remission rate,drug resistance rate and side effects between group 5-FU and 5-FU+Act-D combined chemotherapy.2.The resistance rate of patients with prognosis score was higher than that of 3 points in 4-6 patients.3.For patients with LRGTN with pulmonary metastases,single drug chemotherapy can continue to be selected when the prognostic score is less than 3,while the score at 4?6 can be considered by combined chemotherapy to reduce the incidence of drug resistance.