Treatment results of methotrexate and folinic acid as primary chemotherapy for nonmetastatic gestational trophoblastic neoplasia
Srisomboon, J.; Suprasert, P.; Phongnarisorn, C.; Charoenkwan, K.; Siriaree, S.; Cheewakriangkrai, C.; Tantipalakorn, C.; Kietpeerakool, C.
Journal of the Medical Association of Thailand 88(7): 886-890
2005
ISSN/ISBN: 0125-2208 PMID: 16241014 Document Number: 2583
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.
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