Skip Navigation LinksHome > January 1994 - Volume 83 - Issue 1 > Alternating Weekly Chemotherapy With Etoposide-Methotrexate-...
Obstetrics & Gynecology:
Original Article: PDF Only

Alternating Weekly Chemotherapy With Etoposide-Methotrexate-Dactinomycin/ Cyclophosphamide-Vincristine for High-Risk Gestational Trophoblastic Disease.

SOPER, JOHN T. MD; EVANS, A CRAIG MD; CLARKE-PEARSON, DANIEL L. MD; BERCHUCK, ANDREW MD; RODRIGUEZ, GUSTAVO MD; HAMMOND, CHARLES B. MD

Collapse Box

Abstract

Objective: To evaluate the response rate and toxicity of alternating weekly therapy with etoposide-methotrexatedactinomycin/cyclophosphamide-vincristine for women with high-risk gestational trophoblastic disease.

Methods: Twenty-two women with gestational trophoblastic disease received 126 cycles of the study regimen. Response was evaluated by serial hCG monitoring. Toxicity was assessed using standard criteria.

Results: Six women (27%) were treated for primary therapy and 16 (73%) for secondary therapy. The median prognostic index score was 11 (range 7-19). Only 23% of the patients and 11% of the 126 treatment cycles had grade neutropenia, despite the heavily pretreated patient population. Only 2% of the cycles were associated with neutropenic sepsis or required platelet transfusions. Nonhematologic toxicity was modest. Among 16 women who received chemotherapy alone, there were 11 (69%) complete and three (19%) partial responses. When adjuvant therapies are included, the overall complete and partial response rates were 77 and 14%, respectively. Six (35%) of 17 complete responders developed recurrences. Five patients with partial response or relapse were salvaged with additional therapy. Fifteen of the 22 patients (68%) have sustained remissions.

Conclusion: The regimen of alternating weekly etoposidemethotrexate- dactinomycin/cyclophosphamide-vincristine is effective and well-tolerated chemotherapy for patients with high-risk gestational trophoblastic disease.

(C) 1994 The American College of Obstetricians and Gynecologists

Login

ACOG MEMBER SUBSCRIPTION ACCESS

If you are an ACOG Fellow and have not logged in or registered to Obstetrics & Gynecology, please follow these step-by-step instructions to access journal content with your member subscription.

Article Tools

Share

Article Level Metrics