Comparison of effects of methotrexate/calcium folinate and actinomycin D on trophoblastic tumors

Abstract

Objective: This study aimed to compare the clinical efficacy and safety of a combination of methotrexate (MTX) plus calcium folinate (CF) and actinomycin D (ACT-D) treatment in patients with low-risk trophoblastic tumors. Methods: We included 95 and 101 patients who received chemotherapy with MTX plus CF (MTX + CF group) and ACT-D (ACT-D group). The cure rate, drug resistance rate, number of treatment courses, and adverse reactions were compared between both groups. Results : Age, International Federation of Gynecology and Obstetrics (FIGO) stage and score, prechemotherapy β-human chorionic gonadotropin (HCG) levels, and the nature of the last pregnancy were associated with the development of resistance. Furthermore, age, FIGO stage III, and a hydatidiform mole in the last pregnancy were independent risk factors for gestational trophoblastic neoplasia (GTN) after MTX + CF or ACT-D chemotherapy (P < 0.05). Both MTX + CF and ACT-D had a high cure rate and a low rate of resistance in gestational trophoblastic tumors. The adverse reaction incidence was lower in the MTX + CF group than in the ACT-D group. Conclusions: Advanced age, FIGO stage III, and a hydatidiform mole in the last pregnancy may be associated with the development of resistance to MTX + CF or ACT-D chemotherapy in patients with gestational trophoblastic tumors.

Case Report: Methotrexate and Etoposide as Adjuvant Therapy on Patient with Hydatidiform Moles that Have Growing Rapidly Becomes Gestational Trophoblastic Neoplasia

“…However, approximately 20% until 30% of GTN patients receiving chemotherapy must alter their regimens because of drug resistance, severe side effect and relapse [17], [19] . Age, FIGO stage and score, prechemotherapy -hCG level, and the nature of the previous pregnancy were all found to be associated with drug resistance in univariate analysis [19].…”

“…However, approximately 20% until 30% of GTN patients receiving chemotherapy must alter their regimens because of drug resistance, severe side effect and relapse [17], [19] . Age, FIGO stage and score, prechemotherapy -hCG level, and the nature of the previous pregnancy were all found to be associated with drug resistance in univariate analysis [19]. Another study discovered that a higher WHO scoring system (5-6) and choriocarcinoma diagnosis are both linked to an increased risk of resistance to single agent chemotherapy.…”