Department of Gynecological Oncology, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Int J Gynaecol Obstet. 2012 Jan;116(1):39-42. doi: 10.1016/j.ijgo.2011.08.003. Epub 2011 Oct 11.
To determine the effectiveness of 2 standard chemotherapy regimens for low-risk gestational trophoblastic disease according to the International Federation of Gynecology and Obstetrics (FIGO) staging system.
From 2008 until 2010, 75 women with low-risk gestational trophoblastic disease received either pulsed actinomycin D (n=50) or 5-day methotrexate (n=25). The primary remission rate, the duration of treatment, the number of treatment courses, and the adverse effects were compared.
The complete remission rates were 90% for the actinomycin D group and 68% for the methotrexate group (P=0.018). The mean number of chemotherapy courses administered to achieve complete remission (including courses of second-line therapy) was 3.1 in the methotrexate group and 5.3 in the actinomycin D group (P=0.01). No major adverse effects were experienced in either treatment group and there were no significant differences in terms of adverse effects. Second-line chemotherapy was indicated for 11 patients.
Based on the present study, pulsed actinomycin D seems to be an appropriate first-line treatment for patients with low-risk gestational trophoblastic disease.
根据国际妇产科联合会（FIGO）分期系统，确定 2 种标准化疗方案治疗低危妊娠滋养细胞疾病的疗效。
2008 年至 2010 年，75 例低危妊娠滋养细胞疾病患者接受了脉冲放线菌素 D（n=50）或 5 天甲氨蝶呤（n=25）治疗。比较了主要缓解率、治疗持续时间、治疗疗程数和不良反应。
放线菌素 D 组完全缓解率为 90%，甲氨蝶呤组为 68%（P=0.018）。达到完全缓解（包括二线治疗疗程）所需的平均化疗疗程数，甲氨蝶呤组为 3.1 个，放线菌素 D 组为 5.3 个（P=0.01）。两组均未出现严重不良反应，且不良反应无显著差异。11 例患者需要二线化疗。
根据本研究，脉冲放线菌素 D 似乎是低危妊娠滋养细胞疾病患者的一种合适的一线治疗方法。
