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Submitted: 14 August 2007 Modified: 22 August 2019
HERDIN Record #: PCHRD081307110851

Chemotherapy regimens used in the treatment of gestational trophoblastic neoplasia at Philippine General Hospital: Treatment outcomes and toxicity .

M Stephanie Fay S. Cagayan,
Maria Cresencia C. Gacoba

OBJECTIVE: To describe different chemotherapy regimens used in the treatment of gestational trophoblastic neoplasia (GTN).


METHODS: A retrospective study of GTN cases from January 1999 to December 2004 at Philippine General Hospital was done. Patients with nonmetastatic and metastatic low-risk disease were managed by single-agent chemotherapy. Those with high-risk disease were given multiple-agent chemotherapy.


RESULTS: Forty-five percent of patients (87/193) manifested adverse reactions to chemotherapy. Adverse effects include anemia in 51.7 percent (45/87), leukopenia in 16 percent (14/87), neutropenia in 72.4 percent (63/87) and elevated liver enzymes in 21.8 percent (19/87). Symptoms included vomiting in 9.1 percent (8/87) of cases, diarrhea in 6.8 percent (6/87), stomatitis in 24.14 percent (21/87) and febrile neutropenia in 19.5 percent (17/87). There was a significant difference between the 3 groups of regimens in terms of anemia (p = 0.002), leukopenia (p = 0.011), neutropenia (p < 0.001) and stomatitis (p < 0.001). Patients treated with etoposide, methotrexate, actinomycin (ACT), cyclophosphamide and vincristine and with etoposide, methotrexate, ACT, taxanes and cisplatin experienced most of the toxicity.


CONCLUSION: In the Philippine General Hospital, methotrexate is first-line single-agent chemotherapy for low-risk GTN. Etoposide, methotrexate, ACT, cyclophosphamide and vincristine regimen are the first line for high-risk metastatic GTN. Present regimens are effective but predispose patients to a variety of toxicities. Patients' acceptance and tolerance of adverse effects and ability to secure drug resources are factors contributing to the success of the treatment. (Author)

Publication Type
Journal
Publication Sub Type
Others
Title
The Journal of Reproductive Medicine
Frequency
Monthly
Publication Date
November 2006
Volume
51
Issue
11
Page(s)
907-918
LocationLocation CodeAvailable FormatAvailability
Philippine Council for Health Research and Development Library Box No. 119 / LA Fulltext Print Format (Request Document)
U.S. National Library of Medicine: PubMed/Medline Fulltext pdf (Request Document)