Comparison of weekly methotrexate regimen versus methotrexate folinic acid 8-day regimen for treatment of low-risk gestational trophoblastic neoplasia

被引:1
作者
Korkmaz, Vakkas [1 ]
Sunar, Veli [2 ]
Akar, Serra [1 ]
Alinca, Cihat Murat [1 ]
Arik, Zafer [3 ]
Boran, Nurettin [1 ]
Ozdal, Bulent [4 ]
Ustun, Yaprak Engin [5 ]
机构
[1] Univ Hlth Sci, Fac Med, Etlik Zubeyde Hanim Womens Hlth Training & Res Ho, Dept Gynecol Oncol, Ankara, Turkey
[2] Univ Hlth Sci, Fac Med, Zekai Tahir Burak Womens Hlth Training & Res Hosp, Dept Med Oncol, Ankara, Turkey
[3] Hacettepe Univ, Inst Canc, Dept Med Oncol, Ankara, Turkey
[4] Univ Hlth Sci, Fac Med, Zekai Tahir Burak Womens Hlth Training & Res Hosp, Dept Gynecol Oncol, Ankara, Turkey
[5] Univ Hlth Sci, Fac Med, Etlik Zubeyde Hanim Womens Hlth Training & Res Ho, Dept Gynecol & Obstet, Ankara, Turkey
关键词
gestational trophoblastic neoplasms; methotrexate; response rate; WEEKLY INTRAMUSCULAR METHOTREXATE; DISEASE; CHEMOTHERAPY; MANAGEMENT; CHORIOCARCINOMA; RESISTANCE; DIAGNOSIS;
D O I
10.1111/ajco.13623
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Aim We aimed to compare weekly methotrexate (MTX) regimen and methotrexate-folinic acid (MTX-FA) 8-day regimen in the first line treatment of low-risk gestational trophoblastic neoplasia (GTN). Methods The study included 73 patients with low-risk GTN according to FIGO risk score (FIGO risk score < 7). All patients received either weekly MTX (30-50 mg/m(2) intramuscular weekly) or MTX-FA 8-day (MTX 1 mg/kg IV on day 1, 3, 5, and 7, FA 15 mg orally on day 2, 4, 6, and 8 given 24 h after each MTX dose, every 14 days) regimens in the first-line treatment of low-risk GTN. The baseline clinicopathological characteristics and treatment outcomes were analyzed retrospectively. Results The median age of all patients was 29 (18-51) years, and the median FIGO risk score was 3 (1-6). Of the patients recruited, 53 received MTX-FA 8-day, and 20 had MTX weekly regimens. There was a significant difference between the two groups with respect to FIGO risk scores (3 [1-6] vs. 2 [1-5], p = 0.023, MTX-FA 8-day vs. MTX weekly, respectively). The complete response rate was significantly higher in MTX-FA 8-day group compared to MTX weekly group (83% [44/53] vs. 60% [12/20] p = 0.038). In univariate and multivariate regression analyses, only presence of lung metastasis was found to be an independent risk factor for treatment resistance (OR: 3.959, 95% CI 1.105-14.179, p = 0.035). Conclusion MTX-FA 8-day regimen is more effective than weekly MTX regimen in the first line treatment of low-risk GTN including patients even with higher FIGO risk scores. Treatment resistance may develop especially in patients with lung metastasis.
引用
收藏
页码:326 / 332
页数:7
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