Is Not It the Time to Change the Treatment of Intermediate-Risk Patients Suffering From Gestational Trophoblastic Neoplasia?

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AKHAVAN SETAREH; MODARRES GILANI MITRA; Mousavi Azamosadat; Sheikh Hasani Sahrzad; Nokhostin Fahimeh

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Journal: International Journal of Women's Health and Reproduction Sciences Year:2020 | Volume:8 | Issue:2 Page(s): 153-157

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Title

Is Not It the Time to Change the Treatment of Intermediate-Risk Patients Suffering From Gestational Trophoblastic Neoplasia?

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Keywords

GTN

Intermediate risk

Chemotherapy resistance

Abstract

Objectives: The present study attempted to provide a clear view of gestational trophoblastic neoplasia (GTN) with the focus on resistance to treatment approaches in Iran. Materials and Methods: This retrospective cohort study reviewed the medical records of 272 patients with the definitive diagnosis of GTN referring to Imam Khomeini hospital in Tehran during 2007-2017. Results: The mean age of participants was 29. 19 ± 7. 46 years. The abnormal uterine bleeding (AUB) was the most common clinical manifestation in 64. 3% of patients. Regarding the risk scoring condition according to the World Health Organization criteria, 77. 6%, 9. 1%, and 13. 3% were categorized as low-, intermediate-, and high-risk cases. Single therapy with methotrexate was used in 22. 8% of patients and actinomycin-D was planned for 42. 3% whereas 11. 0% and 1. 5% were considered for treatment with the EMA-CO (Etoposide, methotrexate, actinomycin D, cyclophosphamide, vincristine) and EMA-EP (Etoposide methotrexate and actinomycin-D/etoposide and cisplatin) regimens, respectively. Good response to methotrexate was 66. 7% but it was 83. 6% in the ACT group (P = 0. 001). The resistance to single-agent chemotherapy in low-and intermediate-risk groups was 16% and 92%, respectively. In addition, 20. 2% of patients in stage one had tumor invasion pattern in the uterus in pretreatment Doppler ultrasonography, but 52% and 30% had resistance to chemotherapy treatment in invasive and noninvasive groups, respectively (P = 0. 008). Conclusions: In general, due to the high resistance of the intermediate-risk subgroup to a single therapy, a combination therapy may be more useful to treat this disorder. The close association between tumor invasion pattern in the uterus in Doppler ultrasonography and drug resistance can be considered as a new criterion for tumor risk scoring.

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APA: Copy

AKHAVAN, SETAREH, MODARRES GILANI, MITRA, Mousavi, Azamosadat, Sheikh Hasani, Sahrzad, & Nokhostin, Fahimeh. (2020). Is Not It the Time to Change the Treatment of Intermediate-Risk Patients Suffering From Gestational Trophoblastic Neoplasia?. INTERNATIONAL JOURNAL OF WOMEN’S HEALTH AND REPRODUCTION SCIENCES, 8(2), 153-157. SID. https://sid.ir/paper/751434/en

Vancouver: Copy

AKHAVAN SETAREH, MODARRES GILANI MITRA, Mousavi Azamosadat, Sheikh Hasani Sahrzad, Nokhostin Fahimeh. Is Not It the Time to Change the Treatment of Intermediate-Risk Patients Suffering From Gestational Trophoblastic Neoplasia?. INTERNATIONAL JOURNAL OF WOMEN’S HEALTH AND REPRODUCTION SCIENCES[Internet]. 2020;8(2):153-157. Available from: https://sid.ir/paper/751434/en

IEEE: Copy

SETAREH AKHAVAN, MITRA MODARRES GILANI, Azamosadat Mousavi, Sahrzad Sheikh Hasani, and Fahimeh Nokhostin, “Is Not It the Time to Change the Treatment of Intermediate-Risk Patients Suffering From Gestational Trophoblastic Neoplasia?,” INTERNATIONAL JOURNAL OF WOMEN’S HEALTH AND REPRODUCTION SCIENCES, vol. 8, no. 2, pp. 153–157, 2020, [Online]. Available: https://sid.ir/paper/751434/en

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