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Management of patients with metastatic gestational trophoblastic tumor
Fatemeh Ghaemmaghami1, Nadereh Behtash, Khadijeh Soleimani
1Gynecology Oncology Department, Vali-e-Asr Hospital, Imam Khomeini Hospital Complex, Tehran 14194, Iran. valrec2@yahoo.com
Objective:
This study was designed to analyze the results of treatment on patients with metastatic gestational trophoblastic tumor (metastatic GTT).
Method:
During 1996-2001, 38 cases with metastatic GTT were diagnosed and received treatment in Vali-e-Asr Hospital, Tehran, Iran. Data were gathered retrospectively and analyzed based on therapy and response rate. Sixteen patients initially labeled as low-risk, four as middle-risk and eighteen as high-risk patients according to FIGO scoring system (1992). Thirty-four (89.5%) patients responded to treatment; 13 to single-agent [methotrexate (MTX) or ACT] and 21 to multiagent chemotherapy [EMA/cisplatinum and etoposide (EMA-EP) or MTX, ACT-D and cyclophosphamide or chlorambucil (MAC)].
Results:
All low-risk patients, 2 middle-risk patients and 16 high-risk patients responded to treatment. Four cases failed to respond to therapy due to CNS involvement.
Conclusions:
Patients with low-risk metastatic GTT have a 100% chance to response to single-agent chemotherapy and those with high-risk disease have great chance to response to multiagent chemotherapy such as EMA-EP.
