title: The role of low-dose methotrexate and folinic acid in gestational trophoblastic tumours (GTT).
abstract: Between 1964 and 1986, 487 patients with gestational trophoblastic tumour (GTT) were treated with methotrexate and folinic acid. The patients comprise two groups: between 1964 and 1974, 126 patients were treated but were not systematically stratified using a prognostic score before the start of treatment. These patients formed part of the 317 women who were analysed to identify a number of prognostic variables (Bagshawe 1976). Retrospective analysis of these 126 patients using these prognostic factors showed that in the true low-risk group 85/88 (96%) are alive while 20/22 (91%) of the medium-risk group and only 5/16 (31%) of the high-risk group are alive. Overall the survival was 110/126 (87%) with a minimum follow-up of 14 years. From 1974 all patients were stratified on admission into prognostic groups. Of the true low-risk patients 347/348 survived (99.7%); 13 patients were underscored and treated as low risk when they should have been treated as medium risk, 12 (92%) of these are alive, but nine (69%) needed to change treatment because of drug resistance. While the overall survival in the 1974-1986 group was 359/361 (99%) with a minimum follow-up of 16 months, the survival in all patients (1964-1986) was 469/487 (96%). Although the survival in these patients is excellent it should be noted that 69/348 (20%) low-risk patients had to change treatment because of the development of drug resistance, and a further 23 (6%) needed to change treatment because of drug-induced toxicity.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Medical Oncology, Charing Cross Hospital, London.
authors.forename: K D
authors.initials: KD
authors.lastname: Bagshawe
authors.forename: J
authors.initials: J
authors.lastname: Dent
authors.forename: E S
authors.initials: ES
authors.lastname: Newlands
authors.forename: R H
authors.initials: RH
authors.lastname: Begent
authors.forename: G J
authors.initials: GJ
authors.lastname: Rustin
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008727:Methotrexate / Q000008:administration & dosage; D011247:Pregnancy; D011379:Prognosis; D012189:Retrospective Studies; D014328:Trophoblastic Neoplasms / Q000188:drug therapy* / Q000401:mortality; D014594:Uterine Neoplasms / Q000188:drug therapy* / Q000401:mortality
chemical_list: D002955:Leucovorin; D008727:Methotrexate