Single-dose methotrexate regimen in the treatment of low-risk gestational trophoblastic neoplasia.
OBJECTIVE
The objective of the study was to evaluate the effectiveness of single-dose methotrexate in women with low-risk gestational trophoblastic neoplasia.


METHODS
In this prospective observational cohort study, 105 women with low-risk gestational trophoblastic neoplasia were treated with an intravenous bolus of 100 mg/m2 of methotrexate followed by a 12-hour infusion of 200 mg/m2. If the human chorionic gonadotropin level fell 10-fold after 2 weeks, no further chemotherapy was given. Characteristics between the 2 groups with or without complete remission with this regimen were compared.


RESULTS
The overall complete remission rate with methotrexate was 84.8%, with 44.8% of women requiring a single dose of methotrexate alone. The pretreatment human chorionic gonadotropin level was found to be significantly higher in women who failed the single-dose methotrexate regimen (P = .001), and 10 of 11 patients with metastases required further doses.


CONCLUSIONS
This regimen offers an effective option for women with low-risk gestational trophoblastic neoplasia without metastases and a low pretreatment human chorionic gonadotropin level.
Chan
Karen K L
KK
Department of Obstetrics and Gynecology, University of Hong Kong, Hong Kong. kklchan@hkucc.hku.hk
Huang
Yong
Y
Tam
Kar Fai
KF
Tse
Ka Yu
KY
Ngan
Hextan Y S
HY
D000293:Adolescent; D000328:Adult; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D006063:Chorionic Gonadotropin / Q000097:blood; D015331:Cohort Studies; D004334:Drug Administration Schedule; D005260:Female; D031901:Gestational Trophoblastic Disease / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D007275:Injections, Intravenous; D008727:Methotrexate / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D011247:Pregnancy; D011446:Prospective Studies; D012074:Remission Induction; D019233:Retreatment; D012307:Risk Factors; D016896:Treatment Outcome
D000964:Antimetabolites, Antineoplastic; D006063:Chorionic Gonadotropin; D008727:Methotrexate