title: Management of patients with metastatic gestational trophoblastic tumor.
abstract: OBJECTIVE
  This study was designed to analyze the results of treatment on patients with metastatic gestational trophoblastic tumor (metastatic GTT).
  
  
  METHODS
  During 1996-2001, 38 cases with metastatic GTT were diagnosed and received treatment in Vali-e-Asr Hospital, Tehran, Iran. Data were gathered retrospectively and analyzed based on therapy and response rate. Sixteen patients initially labeled as low-risk, four as middle-risk and eighteen as high-risk patients according to FIGO scoring system (1992). Thirty-four (89.5%) patients responded to treatment; 13 to single-agent [methotrexate (MTX) or ACT] and 21 to multiagent chemotherapy [EMA/cisplatinum and etoposide (EMA-EP) or MTX, ACT-D and cyclophosphamide or chlorambucil (MAC)].
  
  
  RESULTS
  All low-risk patients, 2 middle-risk patients and 16 high-risk patients responded to treatment. Four cases failed to respond to therapy due to CNS involvement.
  
  
  CONCLUSIONS
  Patients with low-risk metastatic GTT have a 100% chance to response to single-agent chemotherapy and those with high-risk disease have great chance to response to multiagent chemotherapy such as EMA-EP.
authors.affiliation: Gynecology Oncology Department, Vali-e-Asr Hospital, Imam Khomeini Hospital Complex, Tehran 14194, Iran. valrec2@yahoo.com
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Ghaemmaghami
authors.forename: Nadereh
authors.initials: N
authors.lastname: Behtash
authors.forename: Khadijeh
authors.initials: K
authors.lastname: Soleimani
authors.forename: Parviz
authors.initials: P
authors.lastname: Hanjani
mesh_terms: D000293:Adolescent; D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects / Q000627:therapeutic use*; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D003609:Dactinomycin / Q000008:administration & dosage / Q000627:therapeutic use*; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D031901:Gestational Trophoblastic Disease / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000903:Antibiotics, Antineoplastic; D000964:Antimetabolites, Antineoplastic; D003609:Dactinomycin; D005047:Etoposide; D003520:Cyclophosphamide; D002945:Cisplatin; D008727:Methotrexate