title: Treatment results of methotrexate and folinic acid as primary chemotherapy for nonmetastatic gestational trophoblastic neoplasia.
abstract: OBJECTIVE
  To evaluate the efficacy and toxicity of methotrexate and folinic acid (MTX-FA) chemotherapy in patients with nonmetastatic gestational trophoblastic neoplasia (NMGTN).
  
  
  METHODS
  Between 1997 and 2003, a total of 67 patients with NMGTN received treatment at the Chiang Mai University Hospital. Of the 67 patients, 55 were initially treated with methotrexate 1.0 mg/kg intramuscularly (IM) on day 1, 3,5, and 7 and folinic acid 0.1 mg/kg IM on day 2, 4, 6 and 8. Treatment courses were repeated every 14 days. Clinical characteristics and outcomes were analyzed
  
  
  RESULTS
  All 55 patients with NMGTN were cured. Of the 55 patients initially treated with MTX-FA, 49 (89%) achieved complete remission. Six (11%) patients developed methotrexate resistance, 3 were cured with actinomycin D, 1 were cured with 5-fluorouracil followed by etoposide, 2 required hystertectomy to attain remission. No serious toxicity was noted
  
  
  CONCLUSIONS
  Methotrexate and folinic acid chemotherapy is highly effective and well-tolerated in treating patients with nonmetastatic gestational trophoblastic neoplasia.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand. jsrisomb@mail.med.cmu.ac.th
authors.forename: Jatupol
authors.initials: J
authors.lastname: Srisomboon
authors.forename: Prapaporn
authors.initials: P
authors.lastname: Suprasert
authors.forename: Chailert
authors.initials: C
authors.lastname: Phongnarisorn
authors.forename: Kittipat
authors.initials: K
authors.lastname: Charoenkwan
authors.forename: Sitthicha
authors.initials: S
authors.lastname: Siriaree
authors.forename: Chalong
authors.initials: C
authors.lastname: Cheewakriangkrai
authors.forename: Charuwan
authors.initials: C
authors.lastname: Tantipalakorn
authors.forename: Chumnan
authors.initials: C
authors.lastname: Kietpeerakool
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D005260:Female; D031901:Gestational Trophoblastic Disease / Q000188:drug therapy*; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D011247:Pregnancy; D016896:Treatment Outcome
chemical_list: D002955:Leucovorin; D008727:Methotrexate