Ovarian dysfunction in patients with gestational trophoblastic neoplasia treated with short intensive courses of etoposide (VP-16-213).
The effect of oral Etoposide (VP-16-213) on the ovarian function in 22 patients with residual gestational trophoblastic disease was studied by serial weekly measurement of serum follicle stimulating hormone (FSH), 17 beta-estradiol (E2), progesterone (P) and prolactin (PRL), and monitoring of the menstrual patterns during and after drug treatment. Multiple courses of VP-16-213 at a dosage of 200 mg/m2 X 5 days were given 1 week apart. Following an average dose of 5.0 gm, five young patients developed transient ovarian failure for a mean period of 2.4 months and two elderly patients developed permanent ovarian failure (total incidence, 7/22, 31.8%) as evidenced by hypergonadotropic, hypoestrogenic amenorrhea. In addition, two patients each developed anovulatory cycles and hypomenorrhea. VP-16-213 should therefore be regarded a potent gonadotoxic drug and these hitherto unreported side effects should be recognized when the drug is used in menstruating females.
Choo
Y C
YC
Chan
S Y
SY
Wong
L C
LC
Ma
H K
HK
D000328:Adult; D000568:Amenorrhea / Q000139:chemically induced*; D006063:Chorionic Gonadotropin / Q000097:blood; D004958:Estradiol / Q000097:blood; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D008875:Middle Aged; D010053:Ovary / Q000187:drug effects*; D010060:Ovulation / Q000187:drug effects; D011034:Podophyllotoxin / Q000031:analogs & derivatives*; D011247:Pregnancy; D011374:Progesterone / Q000097:blood; D011388:Prolactin / Q000097:blood; D011446:Prospective Studies; D014328:Trophoblastic Neoplasms / Q000188:drug therapy*; D014594:Uterine Neoplasms / Q000188:drug therapy*
D006063:Chorionic Gonadotropin; D011374:Progesterone; D004958:Estradiol; D005047:Etoposide; D011388:Prolactin; D005640:Follicle Stimulating Hormone; D011034:Podophyllotoxin