학술논문

Outcomes of women diagnosed and treated for low-risk gestational trophoblastic neoplasia at the Queensland Trophoblast Centre (QTC).
Document Type
Article
Source
Australian & New Zealand Journal of Obstetrics & Gynaecology. Aug2017, Vol. 57 Issue 4, p458-463. 6p.
Subject
*CANCER chemotherapy
*CANCER relapse
*CONSTIPATION
*DRUG resistance in cancer cells
*FATIGUE (Physiology)
*METASTASIS
*METHOTREXATE
*NAUSEA
*RESEARCH funding
*RISK assessment
*TREATMENT effectiveness
*RETROSPECTIVE studies
*TREATMENT duration
*DESCRIPTIVE statistics
*DACTINOMYCIN
*DISEASE complications
*GESTATIONAL trophoblastic disease
*DIAGNOSIS
Language
ISSN
0004-8666
Abstract
Background Gestational trophoblastic neoplasia (GTN) is classified as a highly curable group of pregnancy-related malignancies; however, approximately 15% will be persistent and require chemotherapy. Up to 25% of these women will develop resistance and 2% will develop disease relapse after initial chemotherapy. Despite the need for further chemotherapy in these women, cure rates are high. Objective To evaluate the outcomes of women diagnosed with low-risk GTN, assessing the type of treatment, the number of chemotherapy cycles received, development of resistance or disease relapse, survival, and to assess the feasibility of changing to a new drug regimen. Methods From March 2012 until February 2015, a retrospective study was conducted and 38 cases with low-risk GTN were reviewed. The number of cycles, type of treatment received, duration of treatment, development of resistance and disease relapse, and adverse side effects were analysed. Results The median duration of follow-up was 12 months. Disease-free survival was 100% and primary complete remission rates were achieved in 85.3% of patients who were treated with actinomycin D and 25% patients who were treated with methotrexate (MTX). A change in chemotherapy was required for nine patients. One patient developed disease relapse. Nausea, fatigue and constipation were the most frequent adverse events reported with actinomycin D. All women were cured of their disease. Conclusion All women were successfully treated and achieved complete remission. Changing from MTX to actinomycin D as first-line chemotherapy for women with low-risk GTN was feasible and safe. [ABSTRACT FROM AUTHOR]