August 2nd, 2021

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Management of Gestational Trophoblastic Neoplasia with 5-Fluorouracil and Actinomycin D in Northern China
Authors:  Ying Zhao, M.D., Weiyuan Zhang, M.D., and Wei Duan, M.D.
  OBJECTIVE: To study risk factors associated with the number of chemotherapy courses required to obtain normal b-human chorionic gonadotropin (b-hCG) levels and evaluate the effectiveness of combination chemotherapy using 5-fluorouracil (5-FU) and actinomycin D (Act D) (FA) for gestational trophoblastic neoplasia (GTN).

STUDY DESIGN: A retrospective study of GTN cases from January 1995 to July 2007 at the Beijing Obstetrics and Gynecology Hospital was performed.

RESULTS: During the study period, 240 cases of GTN were diagnosed and managed at our institution. A stepwise regression analysis revealed that the interval between evacuation and chemotherapy, parity, age and b-hCG level were associated with number of chemotherapy courses required to obtain normal b-hCG levels. In addition to 4 patients with placental site trophoblastic tumor, FA was used in 218 patients (136 low risk and 82 high risk).

CONCLUSION: Early detection of GTN and timely administration of chemotherapy decreases the number of chemotherapy courses required. The combination chemotherapy of 5-FU and Act D is effective in low- and high-risk patients with GTN, but not in patients with placental site trophoblastic tumor; it can be used as primary chemotherapy regimen in high-risk patients with GTN, except those with extensive metastases. (J Reprod Med 2009;54:88-94)
Keywords:  actinomycin D, 5-fluorouracil, gestational trophoblastic neoplasia, mole
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