[Combination therapy of advanced choriocarcinoma--an analysis of 60 patients]

From Jan. 1973 to Dec. 1984, 60 patients with advanced choriocarcinoma were treated in our hospital. 34 of them were stage IIIB and 26 stage IV. There were 36 patients with lobulated pulmonary metastases and 13 with brain metastases. The 4-drug chemotherapy (methotrexate or fluorouracil, kengsengmycin, vincristine and nitrogen mustard) was used as the main treatment, supplemented by surgery or irradiation. In those with lobulated pulmonary metastatic foci and lesions in the brain, the 4-drug chemotherapy was used before, during or after split course irradiation. Generally, radiation with a total dose of 4,000 rad (2,000 rad/12 D, interval of 4 weeks, 2,000 rad/12 D) was given after 3-4 courses of chemotherapy. The 1, 3 and 5 year survival rates were 85.7%, 78.6% and 79.4%, respectively. Lobulated pulmonary lesions as treated with 4-drug chemotherapy plus split course irradiation gave a 3 year survival rate of 88.0% (22/25). 7 of 8 with brain metastases treated by the same modality gave complete remission. 5 have survived for more than 3 years. In this series, the combination therapy of advanced choriocarcinoma, role of irradiation for this tumor and individualization in treatment are discussed. The authors believe that the 4-drug chemotherapy for advanced choriocarcinoma is superior to the other regiment and, when combined with split course irradiation is very effective in lobulated pulmonary and brain metastases.