Ghasemian Sedigheh, Yousefi Zohreh, Farazestanian Marjaneh, Mousavi Seresht Leila, Foroughipour Mohsen, Akhlaghi Saeid
Department of Obstetrics and Gynecology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
Department of Obstetrics and Gynecology, Fellowship of Gynecologist Oncologist, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Iran J Pharm Res. 2018 Winter;17(Suppl):38-42.
Methotrexate as a single agent chemotherapy in most women with low risk gestational trophoblastic neoplasia (GTN) has been associated with high treatment rate. Combination of methotrexate with Vitamin A due to reduced number of chemotherapy regime courses is one of the treatment options for patients with low-risk GTN Therefore, this study was performed with aim to determine the efficacy of combination therapy of Methotrexate with Vitamin A in low risk GTN treatment. This randomized clinical trial was performed on 49 patients with low risk gestational trophoblastic neoplasia. The treatment group (Group A = 19 cases) weekly received Methotrexate 50 mg/m, and Vitamin A 200000 IU, intra-muscular, and the control group (Group B = 30 cases) only received Methotrexate 50 mg/m weekly. All patients were followed up for 8 weeks. Then, treatment outcomes were compared between two groups, and response to therapy was assessed in two groups by evaluation of HCG serum level. P < 0.05 was considered significant.Mean of B-HCG serum level after 4 weeks in Group A and Group B was 68.5 mIu/mL and 360 mIu/mL, respectively ( = 0.018), and after 8 weeks was 1 mIu/mL and 12 mIu/mL, respectively ( = 0.074). Combination therapy of Methotrexate and Vitamin A in low risk GTN is associated with shorter duration of chemotherapy.
甲氨蝶呤作为大多数低危妊娠滋养细胞肿瘤（GTN）女性的单药化疗药物，其治疗成功率较高。由于化疗疗程数减少，甲氨蝶呤与维生素A联合使用是低危GTN患者的治疗选择之一。因此，本研究旨在确定甲氨蝶呤与维生素A联合治疗在低危GTN治疗中的疗效。本随机临床试验对49例低危妊娠滋养细胞肿瘤患者进行。治疗组（A组=19例）每周接受甲氨蝶呤50mg/m²和维生素A 200000IU，肌肉注射，对照组（B组=30例）仅每周接受甲氨蝶呤50mg/m²。所有患者随访8周。然后，比较两组的治疗结果，并通过评估血清HCG水平评估两组的治疗反应。P<0.05被认为具有统计学意义。A组和B组4周后血清β-HCG水平的平均值分别为68.5mIU/mL和360mIU/mL（P=0.018），8周后分别为1mIU/mL和12mIU/mL（P=0.074）。甲氨蝶呤与维生素A联合治疗低危GTN可缩短化疗疗程。
