From January 1976 through December 1985, methotrexate (MTX) with citrovorum factor (CF) was administered as primary treatment to 57 patients with low-risk gestational trophoblastic tumor (GTT); 51 patients were non-metastatic and 6 were metastatic GTT. The median number of courses needed to achieve biochemical remission was two (range, 1-7). Complete remission was attained in 95% of non-metastatic GTT patients with postmolar persistent trophoblastic disease, but when choriocarcinoma was histologically confirmed, this fell to 60%. The cure rate of metastatic GTT patients was only 50%. The overall remission rate with the MTX-CF combination was 84.2%. Toxicity was mild, consisting of myelosuppression and mucositis. Fifteen patients were resistant to MTX-CF, or relapsed subsequently, but they all achieved remission with chemotherapy rescue treatment (VP 16 alone, EMA/CO, CHAMOCA). Two patients required a pulmonary lobectomy. They are all still alive in biochemical remission with a median survival of 54 months. Our experience suggests that drug resistance and relapse rate seem related to a beta-HCG value higher than 10(4), an enlarged uterus with myometrial deep involvement, and a histologically confirmed diagnosis of choriocarcinoma. In conclusion, the MTX-CF combination is effective in postmolar GTT, whereas a different therapeutic approach may be considered for a "special" low-risk group of patients, on the basis of prognostic factors.
Bolis, G., Colombo, N., Epis, A., Mangili, G., Vassena, L., Vergadoro, F., et al. (1987). Methotrexate with citrovorum factor in low-risk gestational trophoblastic tumor. TUMORI, 73(3), 309-313.
|Citazione:||Bolis, G., Colombo, N., Epis, A., Mangili, G., Vassena, L., Vergadoro, F., et al. (1987). Methotrexate with citrovorum factor in low-risk gestational trophoblastic tumor. TUMORI, 73(3), 309-313.|
|Tipo:||Articolo in rivista - Articolo scientifico|
|Carattere della pubblicazione:||Scientifica|
|Titolo:||Methotrexate with citrovorum factor in low-risk gestational trophoblastic tumor|
|Autori:||Bolis, G; Colombo, N; Epis, A; Mangili, G; Vassena, L; Vergadoro, F; Belloni, C|
|Data di pubblicazione:||30-giu-1987|
|Appare nelle tipologie:||01 - Articolo su rivista|