Treatment results of methotrexate and folinic acid as primary chemotherapy for nonmetastatic gestational trophoblastic neoplasia

• Main Authors: Srisomboon J., Suprasert P., Phongnarisorn C., Charoenkwan K., Siriaree S., Cheewakriangkrai C., Tantipalakorn C., Kietpeerakool C.
• Format: Article
• Language: English
• Published: 2014
• Online Access: http://www.scopus.com/inward/record.url?eid=2-s2.0-25144505710&partnerID=40&md5=286ea5d40ba6141e1e46b6adbeef8c2b; http://www.ncbi.nlm.nih.gov/pubmed/16241014; http://cmuir.cmu.ac.th/handle/6653943832/1894
• Institution: Chiang Mai University

Objective: To evaluate the efficacy and toxicity of methotrexate and folinic acid (MTX-FA) chemotherapy in patients with nonmetastatic gestational trophoblastic neoplasia (NMGTN) Material and Method: Between 1997 and 2003, a total of 67 patients with NMGTN received treatment at the Chiang Mai University Hospital. Of the 67 patients, 55 were initially treated with methotrexate 1.0 mg/kg intramuscularly (IM) on day 1,3,5, and 7 and folinic acid 0.1 mg/kg IM on day 2,4,6 and 8. Treatment courses were repeated every 14 days. Clinical characteristics and outcomes were analyzed. Results: All 55 patients with NMGTN were cured. Of the 55 patients initially treated with MTX-FA, 49 (89%) achieved complete remission. Six (11%) patients developed methotrexate resistance, 3 were cured with actinomycin D, 1 were cured with 5-fluorouracil followed by etoposide, 2 required hystertectomy to attain remission. No serious toxicity was noted. Conclusion: Methotrexate and folinic acid chemotherapy is highly effective and well-tolerated in treating patients with nonmetastatic gestational trophoblastic neoplasia.