Abstract | AIM: METHODS: We followed 168 low-risk GTN patients who were treated between 2001 and 2011 in Valiasr Hospital, Tehran, Iran. We used a case-control design and studied odds ratios (OR) and corresponding 95% confidence intervals (CI) to evaluate association between drug resistance and different personal and clinical variables. RESULTS: Resistance to sequential single-agent chemotherapy was 19%, although all patients had a complete remission after a combination of chemotherapy and/or surgery. Patients who had International Federation of Gynecology and Obstetrics scores of 5-6 - considered as, the intermediate risk group - had a 14-fold higher resistance compared with the low score patients (OR = 14.28, 95% CI = 5.54-36.81). We found higher risk of resistance among patients with metastasis (OR = 8.42, 95% CI = 2.44-29.07), large tumor size (>3 cm) (OR = 7.73, 95% CI = 1.93-30.91), high β-hCG (>100 000 IU/L) (OR = 5.86, 95% CI = 1.07-32.02) and/or a diagnosis more than 4 months after pregnancy (OR = 3.30, 95% CI = 1.08-10.02), compared with their reference group. We found no priority for the different chemotherapy regimens. CONCLUSION: Intermediate risk GTN patients had a higher risk of resistance to chemotherapy compared with low-risk patients. Clinical trials and cost-effectiveness studies are needed to suggest a better treatment program for the intermediate risk group.
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Authors | Azam Sadat Mousavi, Ashraf Zamani, Faezeh Khorasanizadeh, Mitra Modarres Gilani, Kazem Zendehdel |
Journal | The journal of obstetrics and gynaecology research
(J Obstet Gynaecol Res)
Vol. 41
Issue 5
Pg. 776-83
(May 2015)
ISSN: 1447-0756 [Electronic] Australia |
PMID | 25492546
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology. |
Chemical References |
- Dactinomycin
- Vincristine
- Etoposide
- Cyclophosphamide
- Methotrexate
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Topics |
- Adolescent
- Adult
- Antineoplastic Combined Chemotherapy Protocols
(therapeutic use)
- Case-Control Studies
- Cyclophosphamide
(therapeutic use)
- Dactinomycin
(therapeutic use)
- Drug Resistance, Neoplasm
- Etoposide
(therapeutic use)
- Female
- Gestational Trophoblastic Disease
(drug therapy)
- Humans
- Iran
- Methotrexate
(therapeutic use)
- Middle Aged
- Pregnancy
- Risk Factors
- Vincristine
(therapeutic use)
- Young Adult
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