[New combination chemotherapy against drug-resistant choriocarcinoma]

The remission rates of 373 patients with trophoblastic diseases were analysed according to the change in therapeutic methods. The following results were obtained. 1) In patients in the "low risk" and nonmetastatic "high risk" group, the remission rate was 100%. On the other hand, in those in the metastatic "high risk" group, the remission rate was only 71.4%, even if triple chemotherapy with methotrexate (MTX), actinomycin D (Act-D) and cyclophosphamide (CPM) was given primarily or secondarily. 2) Thirty-two of the patients in the metastatic "high risk" group underwent primary triple chemotherapy. Eleven additional patients in the same group who had never responded to initial chemotherapy of a different regimen had triple chemotherapy. The overall remission rates were 65.6% (21/32) and 45.5% (5/11), respectively. 3) The remission rate in those with recurrence who underwent triple chemotherapy was 44.4% (4/9). But two of these patients had a re-relapse. 4) Six of the patients in the metastatic "high risk" group had MEA protocol with a moderate dose of MTX, Act-D and etoposide. Five of them achieved remission. 5) The side effects of MEA protocol were not so serious, although alopecia and severe anemia were found in 100% and 75.8% of the patients, respectively.