Low-risk gestational trophoblastic neoplasia: A single-center experience from Saudi Arabia
Objective: To report our single-center experience in terms of patient clinical characteristics, treatment outcomes, and chemotherapy-related toxicities in patients with low-risk gestational trophoblastic neoplasia (GTN). Materials and Methods: A retrospective cross-sectional study (2008–2013) was co...
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| Format: | Article |
| Language: | English |
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2019-07-01
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| Series: | Avicenna Journal of Medicine |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.4103/ajm.AJM_188_18 |
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| author | Abdulaziz Alobaid Samer Ahmeed Mohammed Abuzaid Latifa Aldakhil Ahmed Abu-Zaid |
| author_facet | Abdulaziz Alobaid Samer Ahmeed Mohammed Abuzaid Latifa Aldakhil Ahmed Abu-Zaid |
| author_sort | Abdulaziz Alobaid |
| collection | DOAJ |
| description | Objective: To report our single-center experience in terms of patient clinical characteristics, treatment outcomes, and chemotherapy-related toxicities in patients with low-risk gestational trophoblastic neoplasia (GTN). Materials and Methods: A retrospective cross-sectional study (2008–2013) was conducted at a tertiary health-care hospital in Saudi Arabia. Forty-four (n = 44) patients met the inclusion criteria for low-risk GTN. Methotrexate (MTX) was administered in a 5-day regimen: 0.3–0.5mg/kg intravenously (IV) daily for 5 days every 2 weeks (maximum 25mg per dose). Actinomycin D (ActD) was administered 1.25mg/m2 pulsed IV every 2 weeks. Results: The majority of patients had molar pregnancy as the antecedent event (86%), developed GTN within the first 4 months after the initial evacuation (93.2%), had human chorionic gonadotropin levels between 1,000 and 10,000 mIU/dL (36.3%), and had the World Health Organization prognostic scores from 0 to 2 (48.7%). Only 38 patients accepted treatment with chemotherapy. A total of 37 patients received first-line MTX; 34 patients of them achieved complete remission (CR, 92%). The three patients who developed MTX resistance were salvaged with sequential ActD and all achieved CR of 100%. Only one patient received first-line ActD and achieved CR. The overall survival as well as cure rate for all patients with low-risk GTN was 100%. No patient developed MTX-related hepatic toxicity or ActD-related blister formation. No severe adverse effects occurred. Conclusion: Our 5-day IV MTX regimen was highly effective in treating patients with low-risk GTN, with CR rate of 92% and no severe toxicity. Primary and sequential ActD therapy appears to be very effective. |
| first_indexed | 2024-12-13T16:42:10Z |
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| id | doaj.art-7eaf4a2cb57f4f4baad0fbc396f1c61c |
| institution | Directory Open Access Journal |
| issn | 2231-0770 2249-4464 |
| language | English |
| last_indexed | 2024-12-13T16:42:10Z |
| publishDate | 2019-07-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Avicenna Journal of Medicine |
| spelling | doaj.art-7eaf4a2cb57f4f4baad0fbc396f1c61c2022-12-21T23:38:16ZengThieme Medical and Scientific Publishers Pvt. Ltd.Avicenna Journal of Medicine2231-07702249-44642019-07-01903899310.4103/ajm.AJM_188_18Low-risk gestational trophoblastic neoplasia: A single-center experience from Saudi ArabiaAbdulaziz Alobaid0Samer Ahmeed1Mohammed Abuzaid2Latifa Aldakhil3Ahmed Abu-Zaid4Department of Obstetrics and Gynecology, King Fahad Medical City, Riyadh, Kingdom of Saudi ArabiaDepartment of Obstetrics and Gynecology, King Fahad Medical City, Riyadh, Kingdom of Saudi ArabiaDepartment of Obstetrics and Gynecology, King Fahad Medical City, Riyadh, Kingdom of Saudi ArabiaDepartment of Obstetrics and Gynecology, King Khaled University Hospital, Riyadh, Kingdom of Saudi ArabiaCollege of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia; College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, Tennessee, USAObjective: To report our single-center experience in terms of patient clinical characteristics, treatment outcomes, and chemotherapy-related toxicities in patients with low-risk gestational trophoblastic neoplasia (GTN). Materials and Methods: A retrospective cross-sectional study (2008–2013) was conducted at a tertiary health-care hospital in Saudi Arabia. Forty-four (n = 44) patients met the inclusion criteria for low-risk GTN. Methotrexate (MTX) was administered in a 5-day regimen: 0.3–0.5mg/kg intravenously (IV) daily for 5 days every 2 weeks (maximum 25mg per dose). Actinomycin D (ActD) was administered 1.25mg/m2 pulsed IV every 2 weeks. Results: The majority of patients had molar pregnancy as the antecedent event (86%), developed GTN within the first 4 months after the initial evacuation (93.2%), had human chorionic gonadotropin levels between 1,000 and 10,000 mIU/dL (36.3%), and had the World Health Organization prognostic scores from 0 to 2 (48.7%). Only 38 patients accepted treatment with chemotherapy. A total of 37 patients received first-line MTX; 34 patients of them achieved complete remission (CR, 92%). The three patients who developed MTX resistance were salvaged with sequential ActD and all achieved CR of 100%. Only one patient received first-line ActD and achieved CR. The overall survival as well as cure rate for all patients with low-risk GTN was 100%. No patient developed MTX-related hepatic toxicity or ActD-related blister formation. No severe adverse effects occurred. Conclusion: Our 5-day IV MTX regimen was highly effective in treating patients with low-risk GTN, with CR rate of 92% and no severe toxicity. Primary and sequential ActD therapy appears to be very effective.http://www.thieme-connect.de/DOI/DOI?10.4103/ajm.AJM_188_18actinomycin dgestational trophoblastic neoplasiamethotrexatesaudi arabia |
| spellingShingle | Abdulaziz Alobaid Samer Ahmeed Mohammed Abuzaid Latifa Aldakhil Ahmed Abu-Zaid Low-risk gestational trophoblastic neoplasia: A single-center experience from Saudi Arabia Avicenna Journal of Medicine actinomycin d gestational trophoblastic neoplasia methotrexate saudi arabia |
| title | Low-risk gestational trophoblastic neoplasia: A single-center experience from Saudi Arabia |
| title_full | Low-risk gestational trophoblastic neoplasia: A single-center experience from Saudi Arabia |
| title_fullStr | Low-risk gestational trophoblastic neoplasia: A single-center experience from Saudi Arabia |
| title_full_unstemmed | Low-risk gestational trophoblastic neoplasia: A single-center experience from Saudi Arabia |
| title_short | Low-risk gestational trophoblastic neoplasia: A single-center experience from Saudi Arabia |
| title_sort | low risk gestational trophoblastic neoplasia a single center experience from saudi arabia |
| topic | actinomycin d gestational trophoblastic neoplasia methotrexate saudi arabia |
| url | http://www.thieme-connect.de/DOI/DOI?10.4103/ajm.AJM_188_18 |
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