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Comparison between single-agent chemotherapy in low-risk gestational trophoblastic neoplasia
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Leila Mousavi Seresht    , Marjaneh Farazestanian , Zohreh Yousefi |
| Department of Gynecology and Oncology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran , lmousavi.lm.lm@gmail.com |
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Abstract: (1273 Views) |
Background: Low-risk gestational trophoblastic neoplasia could be cured in the case of appropriate management with single-agent chemotherapy. This study was carried out to compare the efficacy of single-dose methotrexate versus Actinomycin-D in low-risk gestational trophoblastic neoplasia to analyze the most effective agent.
Methods: This retrospective cohort study was conducted on the medical record of 170 cases with the diagnosis of low-risk gestational trophoblastic neoplasia from 2012 to 2019 to evaluate the response rate of single-dose weekly-methotrexate versus biweekly-Actinomycin-D.
Results: Single agent chemotherapy was required in 170 patients with final risk score of less than 7. Among the 100 cases under weekly-methotrexate therapy, 29 patients were required second-line chemotherapy with Actinomycin-D and combination therapy which means complete remission of 71% with methotrexate, in comparison with 78.5% in the other group. Resistance was mostly seen in patients with documented choriocarcinoma in histology who had not received timely diagnosis and treatment.
Conclusion: Individualized decision in the management of low-risk gestational trophoblastic neoplasia cases, based on histology, HCG, and history is the corn stone in successful treatment. |
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| Keywords: Actinomycin, Gestational trophoblastic neoplasia, Methotrexate, Outcome, Single-agent chemotherapy. |
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Full-Text [PDF 301 kb]
(373 Downloads)
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Type of Study: Original Article |
Subject:
Oncology
Received: 2021/12/25 | Accepted: 2022/07/3 | Published: 2023/01/21
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