Comparison between single-agent chemotherapy in low-risk gestational trophoblastic neoplasia

• Published in: Caspian journal of internal medicine Vol. 14; no. 1; pp. 108 - 111
• Main Authors: Leila Mousavi Seresht, Marjaneh Farazestanian, Zohreh Yousefi
• Format: Journal Article
• Language: English
• Published: Babol University of Medical Sciences 01.01.2023
• Subjects: actinomycin; gestational trophoblastic neoplasia; methotrexate; outcome; single-agent chemotherapy
• ISSN: 2008-6164; 2008-6172

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.