Combination chemotherapy with 5-fluorouracil, methotrexate and etoposide for patients with high-risk gestational trophoblastic tumors: a report based on our 11-year clinical experiences.
Gynecol Oncol
; 103(3): 1105-8, 2006 Dec.
Article
en En
| MEDLINE
| ID: mdl-16870237
ABSTRACT
OBJECTIVES:
To evaluate the efficacy, toxicity, and survival of patients with high-risk gestational trophoblastic tumors (GTTs) treated with the 5-fluorouracil (5-FU), methotrexate (MTX) and etoposide (VP-16) regimen.METHODS:
Between 1992 and 2003, 26 consecutive patients with FIGO-defined high-risk GTTs were treated with 5-FU, MTX and VP-16 regimen. Among them, 9 patients had received prior chemotherapy. Remission rate, causes of treatment failure, and toxicity were analyzed retrospectively.RESULTS:
After treatment with 5-FU, MTX and VP-16 regimen, 21 of 26 gained complete respond (80.8%). Two patients were performed adjuvant hysterectomy and both cured ultimately. Five developed resistance (19.2%), and 1 died of widespread metastases (3.8%). All 5 patients who developed resistance were treated with multidrug regimen of etoposide, methotrexate, and actionmycin D alternating with cyclophosphamide and vincristine (the EMA/CO); 4 were salvaged and 1 died of refractory disease. No ones relapsed. WHO grade 4 leukocytopenia and thrombocytopenia with the 5-FU, MTX and VP-16 regimen occurred in 9.0% and 2.4%, respectively, of the total 167 cycles; other toxic effects were acceptable and manageable. With mean follow up of 37 months, neither relapse nor secondary tumor was observed.CONCLUSIONS:
According to our 11 years of clinical observation, 5-FU, MTX and VP-16 chemotherapy is one of effective multiagent regimen for patients with high-risk GTTs. Its toxicity is mild and manageable. For patients with high-risk and refractory GTTs, this new triple salvage chemotherapy regimen may be an effective alternative.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neoplasias Uterinas
/
Protocolos de Quimioterapia Combinada Antineoplásica
/
Neoplasias Trofoblásticas
/
Recurrencia Local de Neoplasia
Tipo de estudio:
Etiology_studies
/
Evaluation_studies
/
Risk_factors_studies
Límite:
Female
/
Humans
País/Región como asunto:
Asia
Idioma:
En
Revista:
Gynecol Oncol
Año:
2006
Tipo del documento:
Article