Effectiveness and Efficiency Comparison of One-Day vs Eight-Day Methotrexate Protocols in Managing Low-Risk
Vidiatma Agbari1, Yudi Mulyana Hidayat1, Andi Kurniadi1
1Department of Obstetrics and Gynecology, Faculty of Medicine, Padjadjaran University, Dr Hasan Sadikin General Hospital Bandung, Bandung, West Java, Indonesia.
Background:
Gestational Trophoblastic Neoplasia (GTN) has a high incidence in Bandung, Indonesia, with a mortality rate between 31% and 51%. The most common type is low-risk GTN with various treatment protocols available. The 8-day Methotrexate (MTX) 50 mg protocol has been implemented at our center; however, due to limitation of government insurance, this study aims to compare its effectiveness against the 1-day Methotrexate (MTX) 300 mg/m² protocol.
Methods:
A retrospective cohort study compared two protocols for low-risk GTN treatment at Dr. Hasan Sadikin General Hospital from January 2020 to December 2023: a 1-day Methotrexate (MTX) 300 mg/m² protocol and an 8-day MTX protocol (50 mg MTX IM on days 1, 3, 5, 7 with folinic acid 15 mg orally 24 h after MTX on days 2, 4, 6, 8) and repeat every 2 weeks. Data on patient characteristics, chemotherapy response, side effects, and treatment costs were analyzed.
Results:
The 1-day MTX 300 mg/m² protocol achieved similar remission with fewer cycles, milder side effects, and reduced costs compared to the 8-day MTX 50 mg protocol, supporting it as an effective treatment option for low-risk GTN.
Conclusion:
The 1-day MTX 300 mg/m² protocol is as an effective treatment option for low-risk GTN compared to the 8-day MTX 50 mg protocol.
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