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Resistance to Single-agent Chemotherapy for Low-risk Gestational Trophoblastic Neoplasia
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Shahrzad Sheikhhasani    , Aghdas Abdolrazaghnejad , Azam sadat Mousavi , Setareh Akhavan , Narges Zamani , Elham Feizabad |
| Department of Oncologic Gynecology, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran , dr.abdolrazaghnejad.gynecologist@gmail.com |
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Abstract: (1422 Views) |
Background: Methotrexate (MTX) and actinomycin D (ActD) have been used as first-line chemotherapy agents in the treatment of low-risk gestational trophoblastic neoplasia (GTN). Although low-risk GTN is considered a curable disease, its reported primary remission rates of 49 to 93% reflect the difficulties of treatment and different factors influencing it. Hence, this study aimed to determine the remission rates and related factors of single-agent chemotherapy resistance in low-risk GTN patients.
Methods: This retrospective study included patients with diagnosed low-risk GTN who received either MTX once a week (IM, 30mg/m2) or ActD once every two weeks (pulsed IV, 1.25mg/m2). Then, the patients were followed-up until complete remission or single-agent treatment failure to assess resistance rate and related factors.
Results: Eighty-four patients were included in the study (18 patients were receiving MTX and 66 patients were receiving ActD). 85.7% of all participants achieved complete remission after first-line chemotherapy (72.2% in MTX vs 89.4% in ActD). There was a significant association for higher tumor size (P=0.046), the occurrence of metastasis (P=0.019), and pretreatment β-HCG levels (P=0.005) with resistance to treatment.
Conclusion: This study demonstrated higher tumor size, the occurrence of metastasis, and pretreatment β-HCG levels have been associated with increased resistance to first-line chemotherapy agents. |
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| Keywords: Single-agent chemotherapy, Gestational trophoblastic neoplasia, Dactinomycin, Methotrexate, Treatment failure |
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Full-Text [PDF 292 kb]
(425 Downloads)
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Type of Study: Original Article |
Subject:
Oncology
Received: 2021/12/29 | Accepted: 2022/02/13 | Published: 2023/01/11
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