Alternating methotrexate and dactinomycin in nonmetastatic gestational trophoblastic disease

✍ Scribed by Peter G. Rose; Dr. M. Steven Piver

• Publisher: John Wiley and Sons
• Year: 1989
• Tongue: English
• Weight: 372 KB
• Volume: 41
• Category: Article
• ISSN: 0022-4790
• DOI: 10.1002/jso.2930410304

✦ Synopsis

Alternating 5-day chemotherapy with methotrexate and dactinomycin as primary therapy for nonmetastatic gestational trophoblastic disease was studied in nine patients. The complete response rate was 100% with follow-up of a median of 80 months. Stomatitis was universal but rarely prevented oral alimentation or delayed therapy. Overall, 94% of toxicity was mild or moderate in severity and all toxicity was reversible. This alternating non-cross resistant regimen, reported in a total of 40 patients in the literature, is the only regimen to result in a 100% response rate. This response rate is statistically improved when compared to historical controls receiving methotrexateifolinic acid or pulse dactinomycin. No patients required hysterectomy for disease control. Cooperative prospective phase I11 studies are needed to determine the efficacy and toxicity of current regimens.