Chemotherapy regimens used in the treatment of gestational trophoblastic neoplasia at Philippine General Hospital: treatment outcomes and toxicity.

摘要

OBJECTIVE: To describe different chemotherapy regimens used in the treatment of gestational trophoblastic neoplasia (GTN). METHODS: A retrospective study of GTN cases from January 1999 to December It is important 2004 at Philippine General CONCLUSION: In the Philippine General Hospital, methotrexate is first-line patients single-agent chemotherapy ntitfy those who are rh risk to be able methotrexate, ACT, cyclo-Hospital was done. Patients correctly and idc with nonmetastatic and met- truly low risk vs. phosphamide and vincristine regimen are the first line for high-risk metastatic GTN. Present regimens are effective but predispose patients to a variety of toxicities. Patients' acceptance and tolerance of adverse effects and ability to secure drug resources are factors contributing to the success of the treatment. astatic low-risk disease were managed by single-agent chemotherapy. Those with high-risk disease were given multiple-agent chemotherapy. RESULTS: Forty-five percent of patients (87/193) manifested adverse reactions to chemotherapy. Adverse effects include anemia in 51.7% (45/87), leukopenia in 16% (14/87), neutropenia in 72.4% (63/87) and elevated liver enzymes in 21.8% (19/87). Symptoms included vomiting in 9.1% (8/87) of cases, diarrhea in 6.8% (6/87), stomatitis in 24.14% (21/87) and febrile neutropenia in 19.5% (17/87). There was a significant difference between the 3 groups of regimens in terms of anemia (p = 0.002), leukopenia (p = 0.011), neutropenia (p < 0.001) and stomatitis (p < 0.001). Patients treated with etoposide, methotrexate, actinomycin (ACT), cyclophosphamide and vincristine and with etoposide, methotrexate, ACT, taxanes and cisplatin experienced most of the toxicity. CONCLUSION: In the Philippine General Hospital, methotrexate is first-line single-agent chemotherapy for low-risk GTN. Etoposide, methotrexate, ACT, cyclophosphamide and vincristine regimen are the first line for high-risk metastatic GTN. Present regimens are effective but predispose patients to a variety of toxicities. Patients' acceptance and tolerance of adverse effects and ability to secure drug resources are factors contributing to the success of the treatment.