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- PMID: 11120531
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Article: Methotrexate infusion in low-risk gestational trophoblastic disease
Title | Methotrexate infusion in low-risk gestational trophoblastic disease |
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Authors | |
Keywords | Folinic acid rescue Low-risk gestational trophoblastic disease Methotrexate infusion |
Issue Date | 2000 |
Publisher | Mosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/ajog |
Citation | American Journal Of Obstetrics And Gynecology, 2000, v. 183 n. 6, p. 1579-1582 How to Cite? |
Abstract | OBJECTIVES: The current study attempts to evaluate the effectiveness of methotrexate infusion therapy in the management of low-risk gestational trophoblastic disease and to find out whether an increase in the dose intensity can effect a faster remission and a shorter treatment duration. STUDY DESIGN: This is a prospective study. Between June 1990 and August 1998, 59 patients with low-risk trophoblastic disease were treated with methotrexate at a dose of 100 mg/m 2 as an intravenous bolus over 30 minutes followed by a 12-hour infusion of methotrexate at a dose of 200 mg/m 2. Folinic acid was not given unless the serum methotrexate reached a toxic level 24 hours after infusion (toxic level, 10 μmol/L). Actinomycin D was added in patients with a partial response. The follow-up period of these patients ranged from 12 to 113 months, with a median of 58.5 months and a mean of 55.7 months. RESULTS: Fifty-four patients attained a complete biochemical remission. Twenty-eight patients went into biochemical remission after one methotrexate infusion. Five patients showed a partial biochemical response. A relapse developed in 2 of the 54 complete responders at 3 months and 18 months after the initial therapy. Both patients received combination therapy consisting of methotrexate, etoposide, and bleomycin. They went into biochemical remission and have remained disease-free at the time of analysis. All of the 59 patients were in biochemical remission at the time of analysis. No significant side effects were observed except that Stevens-Johnson syndrome developed in 1 patient. CONCLUSIONS: Methotrexate infusion therapy described in this study is effective in the treatment of low-risk gestational trophoblastic disease. The omission of consolidation therapy and folinic acid rescue decreases the cost and duration of treatment. |
Persistent Identifier | http://hdl.handle.net/10722/173246 |
ISSN | 2023 Impact Factor: 8.7 2023 SCImago Journal Rankings: 3.024 |
ISI Accession Number ID | |
References |
DC Field | Value | Language |
---|---|---|
dc.contributor.author | Wong, LC | en_US |
dc.contributor.author | Ngan, HYS | en_US |
dc.contributor.author | Cheng, DKL | en_US |
dc.contributor.author | Ng, TY | en_US |
dc.date.accessioned | 2012-10-30T06:28:45Z | - |
dc.date.available | 2012-10-30T06:28:45Z | - |
dc.date.issued | 2000 | en_US |
dc.identifier.citation | American Journal Of Obstetrics And Gynecology, 2000, v. 183 n. 6, p. 1579-1582 | en_US |
dc.identifier.issn | 0002-9378 | en_US |
dc.identifier.uri | http://hdl.handle.net/10722/173246 | - |
dc.description.abstract | OBJECTIVES: The current study attempts to evaluate the effectiveness of methotrexate infusion therapy in the management of low-risk gestational trophoblastic disease and to find out whether an increase in the dose intensity can effect a faster remission and a shorter treatment duration. STUDY DESIGN: This is a prospective study. Between June 1990 and August 1998, 59 patients with low-risk trophoblastic disease were treated with methotrexate at a dose of 100 mg/m 2 as an intravenous bolus over 30 minutes followed by a 12-hour infusion of methotrexate at a dose of 200 mg/m 2. Folinic acid was not given unless the serum methotrexate reached a toxic level 24 hours after infusion (toxic level, 10 μmol/L). Actinomycin D was added in patients with a partial response. The follow-up period of these patients ranged from 12 to 113 months, with a median of 58.5 months and a mean of 55.7 months. RESULTS: Fifty-four patients attained a complete biochemical remission. Twenty-eight patients went into biochemical remission after one methotrexate infusion. Five patients showed a partial biochemical response. A relapse developed in 2 of the 54 complete responders at 3 months and 18 months after the initial therapy. Both patients received combination therapy consisting of methotrexate, etoposide, and bleomycin. They went into biochemical remission and have remained disease-free at the time of analysis. All of the 59 patients were in biochemical remission at the time of analysis. No significant side effects were observed except that Stevens-Johnson syndrome developed in 1 patient. CONCLUSIONS: Methotrexate infusion therapy described in this study is effective in the treatment of low-risk gestational trophoblastic disease. The omission of consolidation therapy and folinic acid rescue decreases the cost and duration of treatment. | en_US |
dc.language | eng | en_US |
dc.publisher | Mosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/ajog | en_US |
dc.relation.ispartof | American Journal of Obstetrics and Gynecology | en_US |
dc.subject | Folinic acid rescue | - |
dc.subject | Low-risk gestational trophoblastic disease | - |
dc.subject | Methotrexate infusion | - |
dc.subject.mesh | Adult | en_US |
dc.subject.mesh | Antimetabolites, Antineoplastic - Therapeutic Use | en_US |
dc.subject.mesh | Antineoplastic Agents, Phytogenic - Therapeutic Use | en_US |
dc.subject.mesh | Antineoplastic Combined Chemotherapy Protocols - Therapeutic Use | en_US |
dc.subject.mesh | Bleomycin - Therapeutic Use | en_US |
dc.subject.mesh | Etoposide - Therapeutic Use | en_US |
dc.subject.mesh | Female | en_US |
dc.subject.mesh | Humans | en_US |
dc.subject.mesh | Hydatidiform Mole - Drug Therapy | en_US |
dc.subject.mesh | Infusions, Intravenous | en_US |
dc.subject.mesh | Methotrexate - Therapeutic Use | en_US |
dc.subject.mesh | Neoplasm Recurrence, Local - Drug Therapy | en_US |
dc.subject.mesh | Pregnancy | en_US |
dc.subject.mesh | Prospective Studies | en_US |
dc.subject.mesh | Remission Induction | en_US |
dc.subject.mesh | Risk Factors | en_US |
dc.title | Methotrexate infusion in low-risk gestational trophoblastic disease | en_US |
dc.type | Article | en_US |
dc.identifier.email | Ngan, HYS:hysngan@hkucc.hku.hk | en_US |
dc.identifier.authority | Ngan, HYS=rp00346 | en_US |
dc.description.nature | link_to_subscribed_fulltext | en_US |
dc.identifier.doi | 10.1067/mob.2000.108077 | en_US |
dc.identifier.pmid | 11120531 | - |
dc.identifier.scopus | eid_2-s2.0-0034519035 | en_US |
dc.relation.references | http://www.scopus.com/mlt/select.url?eid=2-s2.0-0034519035&selection=ref&src=s&origin=recordpage | en_US |
dc.identifier.volume | 183 | en_US |
dc.identifier.issue | 6 | en_US |
dc.identifier.spage | 1579 | en_US |
dc.identifier.epage | 1582 | en_US |
dc.identifier.isi | WOS:000165952000053 | - |
dc.publisher.place | United States | en_US |
dc.identifier.scopusauthorid | Wong, LC=7402092003 | en_US |
dc.identifier.scopusauthorid | Ngan, HYS=34571944100 | en_US |
dc.identifier.scopusauthorid | Cheng, DKL=7402806161 | en_US |
dc.identifier.scopusauthorid | Ng, TY=7402229853 | en_US |
dc.identifier.issnl | 0002-9378 | - |