Management of gestational trophoblastic neoplasia with 5-fluorouracil and actinomycin D in northern China.

Abstract

OBJECTIVE:

To study risk factors associated with the number of chemotherapy courses required to obtain normal beta-human chorionic gonadotropin (beta-hCG) levels and evaluate the effectiveness of combination chemotherapy using 5-fluorouracil (5-FU) and actinomycin D (Act D) (FA) for gestational trophoblastic neoplasia (GTN).

STUDY DESIGN:

A retrospective study of GTN cases from January 1995 to July 2007 at the Beijing Obstetrics and Gynecology Hospital was performed.

RESULTS:

During the study period, 240 cases of GTN were diagnosed and managed at our institution. A stepwise regression analysis revealed that the interval between evacuation and chemotherapy, parity, age and beta-hCG level were associated with number of chemotherapy courses required to obtain normal beta-hCG levels. In addition to 4 patients with placental site trophoblastic tumor, FA was used in 218 patients (136 low risk and 82 high risk).

CONCLUSION:

Early detection of GTN and timely administration of chemotherapy decreases the number of chemotherapy courses required. The combination chemotherapy of 5-FU and Act D is effective in low- and high-risk patients with GTN, but not in patients with placental site trophoblastic tumor; it can be used as primary chemotherapy regimen in high-risk patients with GTN, except those with extensive metastases.

• Authors: Ying Zhao, Weiyuan Zhang, Wei Duan
• Journal: The Journal of reproductive medicine (J Reprod Med) Vol. 54 Issue 2 Pg. 88-94 (Feb 2009) ISSN: 0024-7758 [Print] United States
• PMID: 19301571 (Publication Type: Journal Article)

Chemical References

• Dactinomycin
• Fluorouracil

Topics

• Adult
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage)
• China
• Cohort Studies
• Dactinomycin (administration & dosage)
• Female
• Fluorouracil (administration & dosage)
• Humans
• Hydatidiform Mole (drug therapy, pathology)
• Neoplasm Staging
• Pregnancy
• Retrospective Studies
• Treatment Outcome
• Trophoblastic Tumor, Placental Site (drug therapy, pathology)
• Young Adult