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  • Title: Weekly methotrexate (50mg/m(2)) without dose escalation as a primary regimen for low-risk gestational trophoblastic neoplasia.
    Author: Kang WD, Choi HS, Kim SM.
    Journal: Gynecol Oncol; 2010 Jun; 117(3):477-80. PubMed ID: 20347479.
    Abstract:
    OBJECTIVES: The aim of this study was to compare the efficacy and toxicity of an 8-day methotrexate-folinic acid regimen and a weekly methotrexate regimen (50mg/m(2) without dose escalation) for low-risk gestational trophoblastic neoplasia (GTN) according to the revised FIGO 2000 scoring system in a single institution. METHODS: Between January 1997 and June 2007, 107 patients with low-risk GTN were treated with an 8-day methotrexate-folinic acid regimen (MTX-FA group; n=59) or a weekly methotrexate regimen (50mg/m(2) without dose escalation) (MTX group; n=48). The primary remission rate, change of chemotherapy because of drug resistance or toxicity, and relapse rate were compared. RESULTS: All 107 patients with low-risk GTN were cured. The primary remission rates were 69.5% and 70.8% for the MTX-FA and MTX groups, respectively (P>0.99). The commonly reported toxic effects in the MTX-FA and MTX groups, respectively, were as follows: hepatotoxicity (31/59 and 9/48), neutropenia (7/59 and 4/48), stomatitis (3/59 and 2/48), alopecia (2/59 and 2/48), and thrombocytopenia (2/59 and 0/48). Drug toxicity necessitating changes in chemotherapy were reported to be 13.6% (8/59) in the MTX-FA group and 2.1% (1/48) in the MTX group (P<0.05). The overall duration of treatment was 8.6 weeks in the MTX-FA group and 6.4 weeks in the MTX group (P<0.001). CONCLUSIONS: The weekly methotrexate regimen was as effective as the 8-day methotrexate-folinic acid regimen for low-risk GTN. The weekly methotrexate regimen was less toxic, better tolerated, and more convenient for patients compared to the 8-day methotrexate-folinic acid regimen.
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