[Significance of serum/cerebrospinal fluid human chorionic gonadotropin ratio and prophylactic intrathecal therapy in patients with brain metastases of gestational trophoblast tumor].

ABSTRACT

OBJECTIVE: To evaluate the effect of serum/cerebrospinal fluid (CSF) ratio of human chorionic gonadotropin (hCG) in detecting brain metastases of gestational trophoblast tumor and the significance of prophylactic intrathecal therapy. METHODS: Clinical information of 44 patients with brain metastases (stage IV) and 29 patients with lung metastases (stage III) of gestational trophoblast tumor who were admitted to our hospital between 1986 to 2001 were retrospectively analyzed by case control study. The variability of the ratio and the relationship between brain metastases was investigated, together with the effect of prophylactic intrathecal therapy. RESULTS: Serum/CSF hCG ratio in patients with brain metastases declined with time. The ratio before chemotherapy was in relevant with the size of the lesion which were less than 60 in advanced stages and more than 60 in early stages. Patients of stage III with prophylactic intrathecal therapy did not progress to stage IV. CONCLUSIONS: Serum/CSF hCG ratio before chemotherapy could reflect the encephalic tumor load which had reference value in diagnosis and prognosis and prophylactic intrathecal therapy played an important role in preventing brain metastasis.