title: Treatment of high-risk gestational trophoblastic disease with chemotherapy combinations containing cisplatin and etoposide.
abstract: The authors have treated 22 patients with high-risk gestational trophoblastic disease (GTD) by cisplatin-etoposide-containing combinations. Sixteen patients were treated with dactinomycin, platinum, and etoposide combination (APE regimen) and six patients had platinum and etoposide combination (PE regimen). Fourteen patients were treated for resistant or relapsing GTD after first-line therapy, and eight patients initially. All 22 patients were high risk according to the World Health Organization prognostic score values. Sustained complete remission was achieved in 19 patients (86%). All eight patients who received treatment as initial therapy were cured (100%) whereas only 11 patients were cured among the 14 patients who failed prior chemotherapy (78%). Hematologic and renal toxicities were limited and no treatment-related deaths occurred in this group of patients. Cisplatin and etoposide could be more widely used in chemotherapeutic combinations for high-risk gestational trophoblastic disease.
authors.affiliation: Department of Medical Oncology, Institut Gustave-Roussy, Villejuif, France.
authors.forename: C
authors.initials: C
authors.lastname: Theodore
authors.forename: M
authors.initials: M
authors.lastname: Azab
authors.forename: J P
authors.initials: JP
authors.lastname: Droz
authors.forename: A
authors.initials: A
authors.lastname: Assouline
authors.forename: M
authors.initials: M
authors.lastname: George
authors.forename: G
authors.initials: G
authors.lastname: Piot
authors.forename: D
authors.initials: D
authors.lastname: Bellet
authors.forename: G
authors.initials: G
authors.lastname: Michel
authors.forename: J L
authors.initials: JL
authors.lastname: Amiel
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003609:Dactinomycin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D010298:Parity; D011247:Pregnancy; D011379:Prognosis; D012074:Remission Induction; D014328:Trophoblastic Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000556:secondary; D014594:Uterine Neoplasms / Q000097:blood / Q000188:drug therapy*
chemical_list: D003609:Dactinomycin; D005047:Etoposide; D002945:Cisplatin