Methotrexate for 2000 FIGO low-risk gestational trophoblastic neoplasia patients: efficacy and toxicity

Am J Obstet Gynecol. 2009 Jun;200(6):643.e1-6. doi: 10.1016/j.ajog.2009.03.011. Epub 2009 Apr 23.

Abstract

Objective: We sought to review efficacy and toxicity of an 8-day methotrexate (MTX) regimen in the treatment of patients with low-risk gestational trophoblastic neoplasia (GTN) from the French Trophoblastic Disease Reference Center.

Study design: Between 1999 and 2006, 142 low-risk GTNs were diagnosed according to International Federation of Gynecology and Obstetrics (FIGO) criteria for GTN and to the FIGO scoring system. We report their characteristics, remission/resistance/recurrence rates, and treatment toxicity.

Results: The 8-day MTX regimen achieved a 77.5% remission rate. All patients but 1 (99.9%) achieved remission and remained disease free until the time of analysis. Severe (grade 3 or 4) blood/bone marrow toxicity and metabolic/laboratory toxicity was noted in 4.2% of cases, of which 2 (1.4%) were grade 4.

Conclusion: For patients with GTN diagnosed according to FIGO criteria and considered low risk according to the FIGO scoring system, an 8-day MTX regimen is an adequate treatment associating a high rate of remission to a low rate of toxicity.

MeSH terms

  • Adolescent
  • Adult
  • Antimetabolites, Antineoplastic / therapeutic use*
  • Antimetabolites, Antineoplastic / toxicity
  • Female
  • Gestational Trophoblastic Disease / classification
  • Gestational Trophoblastic Disease / drug therapy*
  • Humans
  • Methotrexate / therapeutic use*
  • Methotrexate / toxicity
  • Middle Aged
  • Pregnancy
  • Risk Factors
  • Young Adult

Substances

  • Antimetabolites, Antineoplastic
  • Methotrexate