Comparison of MACT and 5Fu+ACT-D chemotherapy regimens in the treatment of low-risk gestational trophoblastic neoplasia.
The study aimed to compare the efficacy of methotrexate (MTX) cervical injections + actinomycin-D (ACT-D)(MACT) and 5-fluorouracil (5-Fu) + actinomycin-D (5-Fu plus ACT-D) chemotherapy regimens for low-risk gestational trophoblastic neoplasia (LR-GTN). Clinical data from 66 LR-GTN patients, admitted to the Beijing Obstetrics and Gynecology Hospital from January 2010 to April 2012, were analysed retrospectively. In total, 32 patients were treated with a MACT therapeutic regimen and the remaining 34 with a 5Fu + ACT-D therapeutic regimen. Complete remission rates (CR), duration of treatment, hospital stay and toxicity effects were compared. There was no statistical difference in CR for the MACT (90.63%) or the 5-Fu plus ACT-D (100%) therapeutic regimens (p = 0.0676) or in the duration of treatment [MACT (3.50) or 5-Fu plus ACT-D (3.71; p = 0.2021)]. Moreover, the hospital stay in the 5-Fu plus ACT-D group (32.88 days) was significantly longer than for the MACT group (22.09 days; p ＜ 0.001). Furthermore, the degree of myelosuppression, nausea and vomiting, diarrhoea, stomatitis and alopecia was more severe in the 5Fu + ACT-D group (p ＜ 0.01). However, there was no statistical difference in the severity of liver function damage between the two groups. A shorter hospital stay, lower hospitalization cost and slightly more toxic effects were observed in LR-GTN patients treated with the MACT therapeutic regimen. We suggest that the MACT regimen should be used as first-line chemotherapy for LR-GTN.
a Department of Oncology , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , China.
Yu
Y
Wang
a Department of Oncology , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , China.
Jin-Wei
JW
Miao
a Department of Oncology , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , China.
Tong
T
Wang
a Department of Oncology , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , China.
Yan
Y
Wang
a Department of Oncology , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , China.
Yu-Mei
YM
Wu
a Department of Oncology , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , China.
Wei-Min
WM
Kong
a Department of Oncology , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , China.
Li
L
Su
a Department of Oncology , Beijing Obstetrics and Gynecology Hospital, Capital Medical University , Beijing , China.
Wei
W
Duan
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003609:Dactinomycin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D031901:Gestational Trophoblastic Disease / Q000188:drug therapy*; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D011247:Pregnancy; D012189:Retrospective Studies; D012306:Risk; D016896:Treatment Outcome; D055815:Young Adult
D003609:Dactinomycin; D005472:Fluorouracil; D008727:Methotrexate
Drug therapy; Gestational trophoblastic disease; Treatment outcome