Methotrexate, bleomycin, and etoposide in the treatment of gestational trophoblastic neoplasia

被引:5
作者
Ngan, Hextan Y. S. [1 ]
Tam, Kar-Fai [1 ]
Lam, Ka-Wai [1 ]
Chan, Karen K. L. [1 ]
机构
[1] Queen Mary Hosp, Dept Obstet & Gynaecol, Hong Kong, Hong Kong, Peoples R China
关键词
D O I
10.1097/01.AOG.0000207577.67765.8e
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
OBJECTIVE: The combination of methotrexate (1 g/m(2) day 1), bleomycin (10 mg day 3), and etoposide (100 mg/m(2) days 1-5) (MBE) has been used for disease relapse or as a second-line chemotherapy in the treatment of gestational trophoblastic neoplasia (GTN) resistant to multiple-agent chemotherapy. With the identification of ultra-high-risk GTN, MBE has also been used as first-line chemotherapy. The current study is to review the use of MBE in the treatment of GTN. METHODS: Patients who received MBE for GTN between 1985 and 2003 in Queen Mary Hospital were included in this study. Records were reviewed and data were analyzed. Outcomes including response rate, treatment complications, and survival were assessed. RESULTS: Methotrexate, bleomycin, and etoposide therapy was given as first line to 4 patients with ultra-high-risk GTN. Three responded to the treatment and remained disease free. Methotrexate, bleomycin, and etoposide were given as a second-line therapy to 8 patients who had drug resistance to the initial therapy. Seven responded, and 6 remained disease free at 5 years. Methotrexate, bleomycin, and etoposide were given as a second-line therapy to 8 patients who relapsed 2-18 months after their initial therapy. Seven patients responded, and 4 remained disease-free at 5 years, 2 defaulted, and one died of carcinoma of the colon. Of the 20 patients who received MBE, 12 developed grade 3/4 neutropenia, and 4 developed grade 3/4 thrombocytopenia. The overall response rate for MBE was 85%. CONCLUSION: Methotrexate, bleomycin, and etoposide should be considered as a second-line therapy in patients who have drug-resistant or recurrent GTN.
引用
收藏
页码:1012 / 1017
页数:6
相关论文
共 29 条
  • [1] Bagshawe K D, 1976, J Clin Pathol Suppl (R Coll Pathol), V10, P140
  • [2] BERTINO JR, 1981, CANCER TREAT REP, V65, P131
  • [3] BLUM RH, 1973, CANCER, V31, P903, DOI 10.1002/1097-0142(197304)31:4<903::AID-CNCR2820310422>3.0.CO
  • [4] 2-N
  • [5] EMA/CO REGIMEN IN HIGH-RISK GESTATIONAL TROPHOBLASTIC TUMOR (GTT)
    BOLIS, G
    BONAZZI, C
    LANDONI, F
    MANGILI, G
    VERGADORO, F
    ZANABONI, F
    MANGIONI, C
    [J]. GYNECOLOGIC ONCOLOGY, 1988, 31 (03) : 439 - 444
  • [6] EMA/CO for high-risk gestational trophoblastic tumors: Results from a cohort of 272 patients
    Bower, M
    Newlands, ES
    Holden, L
    Short, D
    Brock, C
    Rustin, GJS
    Begent, RHJ
    Bagshawe, KD
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 1997, 15 (07) : 2636 - 2643
  • [7] BOWER M, 1997, J CLIN ONCOL, V15, P3168
  • [8] Treatment of high-risk gestational trophoblastic neoplasia with etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine chemotherapy
    Escobar, PF
    Lurain, JR
    Singh, DK
    Bozorgi, K
    Fishman, DA
    [J]. GYNECOLOGIC ONCOLOGY, 2003, 91 (03) : 552 - 557
  • [9] *FIGO ONC COMM, 1992, INT J GYNECOL OBSTET, V39, P149
  • [10] Treatment of gestational trophoblastic tumors.
    Lurain J.R.
    [J]. Current Treatment Options in Oncology, 2002, 3 (2) : 113 - 124