Abstract: All patients with refractory gestational trophoblastic neoplasia （GTN） require re-assessment of the extent of disease before initiating another treatment. Salvage chemotherapy with multiagent combination is still the main treatment option at present. For the patients with resectable lesions，it is crucial to perform a complete surgical excision of tumors simultaneously during salvage chemotherapy. In addition，these patients may also benefit from the emerging immunotherapy. After remission is achieved，serum human chorionic gonadotrophin （hCG） should be monitored regularly in a long term.

Key words: gestational trophoblastic neoplasia, refractory, chemotherapy, surgery, immunotherapy

摘要： 难治性妊娠滋养细胞肿瘤再次治疗前，需要对疾病程度进行重新评估。多药联合挽救化疗仍是目前主要的治疗手段。对于病灶可切除干净的患者，同时联合手术治疗至关重要。此外，新兴的免疫治疗，给这些难治患者亦提供了新的治疗选择。治疗缓解后，需长期规律监测血人绒毛膜促性腺激素。

关键词: 妊娠滋养细胞肿瘤, 难治, 化疗, 手术治疗, 免疫治疗