title: [Etopside, methotrexate, kengshengmycin/etopside, cisplatin chemotherapy for chemorefractory gestational trophoblastic tumour].
abstract: OBJECTIVE
  To evaluate the results of etopside, methotrexate, kengshengmycin/etopside, cisplatin (EMA/EP) chemotherapy in patients with chemorefractory gestational trophoblastic tumour.
  
  
  METHODS
  Fifteen patients with chemorefractory gestational trophoblastic tumour were treated by EMA/EP chemotherapy schedule.
  
  
  RESULTS
  Twelve of the fifteen cases were choriocarcinoma, and the other three were metastatic placental site trophoblastic tumour (PSTT). International Federation of Gynecology and Obstetrics (FIGO), 2 cases stage I, 10 cases stage III, 3 cases stage IV. Eight cases had FIGO score of 7 to 12, the score of the other 7 cases was over 12. Fifteen patients received a total of 93 cycles of the study regimen. The median number of courses for each patient was 6.2. Eleven cases (73%) achieved a complete remission while 3 patients (20%) had a partial remission, 1 case (7%) showed nonresponse. The main complications for EMA/EP chemotherapy were myelosuppression and gastrointestinal symptoms.
  
  
  CONCLUSIONS
  The EMA/EP regimen is an effective treatment for chemorefractory gestational trophoblastic tumour, and the chemotherapeutic results can be further improved while combined with surgery and arterial infusion chemotherapy in the selected patients. Meanwhile, EMA/EP regimen should be considered in the primary management of patients with metastatic PSTT.
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Xiang
authors.forename: Xi-run
authors.initials: XR
authors.lastname: Wan
authors.forename: Zhi-jing
authors.initials: ZJ
authors.lastname: Sun
authors.forename: Xiu-yu
authors.initials: XY
authors.lastname: Yang
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003609:Dactinomycin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D019008:Drug Resistance, Neoplasm; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D031901:Gestational Trophoblastic Disease / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007970:Leukopenia / Q000209:etiology; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D009367:Neoplasm Staging; D011247:Pregnancy; D016896:Treatment Outcome; D018245:Trophoblastic Tumor, Placental Site / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D014594:Uterine Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery
chemical_list: D003609:Dactinomycin; D005047:Etoposide; D002945:Cisplatin; D008727:Methotrexate