Chemotherapy regimens used in the treatment of gestational trophoblastic neoplasia at Philippine General Hospital: treatment outcomes and toxicity.
OBJECTIVE
To describe different chemotherapy regimens used in the treatment of gestational trophoblastic neoplasia (GTN).


METHODS
A retrospective study of GTN cases from January 1999 to December It is important 2004 at Philippine General


CONCLUSIONS
In the Philippine General Hospital, methotrexate is first-line patients single-agent chemotherapy ntitfy those who are rh risk to be able methotrexate, ACT, cyclo-Hospital was done. Patients correctly and idc with nonmetastatic and met- truly low risk vs. phosphamide and vincristine regimen are the first line for high-risk metastatic GTN. Present regimens are effective but predispose patients to a variety of toxicities. Patients' acceptance and tolerance of adverse effects and ability to secure drug resources are factors contributing to the success of the treatment. astatic low-risk disease were managed by single-agent chemotherapy. Those with high-risk disease were given multiple-agent chemotherapy.


RESULTS
Forty-five percent of patients (87/193) manifested adverse reactions to chemotherapy. Adverse effects include anemia in 51.7% (45/87), leukopenia in 16% (14/87), neutropenia in 72.4% (63/87) and elevated liver enzymes in 21.8% (19/87). Symptoms included vomiting in 9.1% (8/87) of cases, diarrhea in 6.8% (6/87), stomatitis in 24.14% (21/87) and febrile neutropenia in 19.5% (17/87). There was a significant difference between the 3 groups of regimens in terms of anemia (p = 0.002), leukopenia (p = 0.011), neutropenia (p < 0.001) and stomatitis (p < 0.001). Patients treated with etoposide, methotrexate, actinomycin (ACT), cyclophosphamide and vincristine and with etoposide, methotrexate, ACT, taxanes and cisplatin experienced most of the toxicity.


CONCLUSIONS
In the Philippine General Hospital, methotrexate is first-line single-agent chemotherapy for low-risk GTN. Etoposide, methotrexate, ACT, cyclophosphamide and vincristine regimen are the first line for high-risk metastatic GTN. Present regimens are effective but predispose patients to a variety of toxicities. Patients' acceptance and tolerance of adverse effects and ability to secure drug resources are factors contributing to the success of the treatment.
Cagayan
M Stephanie Fay S
MS
Department of Pharmacology and Toxicology, Section of Trophoblastic Diseases, University of the Philippines-Philippine General Hospital, Manila, The Philippines. faye_cagayan@hotmail.com
Gacoba
Maria Cresencia C
MC
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003906:Developing Countries; D005260:Female; D031901:Gestational Trophoblastic Disease / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010679:Philippines; D011247:Pregnancy; D012189:Retrospective Studies