Single-agent chemotherapy for nonmetastatic gestational trophoblastic neoplasia. Perspectives for the 21st century after three decades of use.

After 30 years of successful chemotherapy for nonmetastatic gestational trophoblastic neoplasia, methotrexate and actinomycin remain the most effective and widely used agents. Though cost effectiveness is a consideration, primary efficacy may be a more important factor in this curable malignant disease. The criteria used for diagnosing neoplasia and for making therapeutic decisions were evaluated critically.