دورية أكاديمية
Treatment for low-risk gestational trophoblastic disease: comparison of single-agent methotrexate, dactinomycin and combination regimens.
| العنوان: | Treatment for low-risk gestational trophoblastic disease: comparison of single-agent methotrexate, dactinomycin and combination regimens. |
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| المؤلفون: | Abrão RA; Department of Gynecology and Obstetrics, Hospital das Clínicas of Ribeirão Preto School of Medicine, University of São Paulo, Ribeirao Preto, São Paulo, 14048-900, Brazil., de Andrade JM, Tiezzi DG, Marana HR, Candido dos Reis FJ, Clagnan WS |
| المصدر: | Gynecologic oncology [Gynecol Oncol] 2008 Jan; Vol. 108 (1), pp. 149-53. Date of Electronic Publication: 2007 Oct 10. |
| نوع المنشور: | Comparative Study; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Academic Press Country of Publication: United States NLM ID: 0365304 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1095-6859 (Electronic) Linking ISSN: 00908258 NLM ISO Abbreviation: Gynecol Oncol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: New York, Academic Press. |
| مواضيع طبية MeSH: | Antineoplastic Combined Chemotherapy Protocols/*therapeutic use , Dactinomycin/*therapeutic use , Gestational Trophoblastic Disease/*drug therapy , Methotrexate/*therapeutic use, Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Dactinomycin/administration & dosage ; Dactinomycin/adverse effects ; Female ; Gestational Trophoblastic Disease/pathology ; Humans ; Methotrexate/administration & dosage ; Methotrexate/adverse effects ; Middle Aged ; Neoplasm Staging ; Pregnancy ; Retrospective Studies ; Risk Factors |
| مستخلص: | Objectives: To compare the efficacy of three different standard chemotherapy regimens for low-risk gestational trophoblastic disease according to the FIGO staging system in a single-institute setting. Methods: From 1980 until 2002, we retrospectively reviewed 108 cases with low-risk persistent gestational trophoblastic disease who were treated with first-line chemotherapy. Patients were divided in three groups according to chemotherapy regimen: patients treated with methotrexate (MTX group; n=42), patients treated with dactinomycin (ACT group; n=42) and patients treated with methotrexate and dactinomycin in combination (MACT group; n=24). We compared the number of chemotherapy courses for achieving remission, the duration of treatment, the adverse side effects, the efficacy of the treatment and the need for performing a hysterectomy among the groups Results: The complete remission rates were 69%, 61.4% and 79.1% for methotrexate (MTX), dactinomycin (ACT) and the combination regimen (MACT) treated groups, respectively (p=0.7). The duration of the treatment and the number of chemotherapy courses were similar among the groups (p=0.2 and p=0.4, respectively). Adverse side effects rate was reported to be 62.5% in the MACT group, 28.6% in the MTX group and 19.1% in the ACT group (p=0.0003). Second-line chemotherapy was indicated for 30 patients. Hysterectomy was performed in 21 patients overall, and there was no difference among the groups (p=0.6). Conclusion: Our analysis indicates that single-agent chemotherapy regimens are as effective as combination chemotherapy for low-risk gestational trophoblastic disease. Dactinomycin is a less toxic drug and might offer the best cost-effective treatment option. Methotrexate must be considered as the regimen of choice for low resource areas because of the feasibility of its administration. |
| المشرفين على المادة: | 1CC1JFE158 (Dactinomycin) YL5FZ2Y5U1 (Methotrexate) |
| تواريخ الأحداث: | Date Created: 20071013 Date Completed: 20080115 Latest Revision: 20131121 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1016/j.ygyno.2007.09.006 |
| PMID: | 17931696 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1095-6859 |
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| DOI: | 10.1016/j.ygyno.2007.09.006 |