dc.creator | ABRAO, Renato Antonio | |
dc.creator | ANDRADE, Jurandyr Moreira de | |
dc.creator | TIEZZI, Daniel Guimaraes | |
dc.creator | MARANA, Heitor Ricardo Cosiski | |
dc.creator | REIS, Francisco Jose Candido dos | |
dc.creator | CLAGNAN, Willian Simoes | |
dc.date.accessioned | 2012-10-19T23:01:18Z | |
dc.date.accessioned | 2018-07-04T15:18:14Z | |
dc.date.available | 2012-10-19T23:01:18Z | |
dc.date.available | 2018-07-04T15:18:14Z | |
dc.date.created | 2012-10-19T23:01:18Z | |
dc.date.issued | 2008 | |
dc.identifier | GYNECOLOGIC ONCOLOGY, v.108, n.1, p.149-153, 2008 | |
dc.identifier | 0090-8258 | |
dc.identifier | http://producao.usp.br/handle/BDPI/24577 | |
dc.identifier | 10.1016/j.ygyno.2007.09.006 | |
dc.identifier | http://dx.doi.org/10.1016/j.ygyno.2007.09.006 | |
dc.identifier.uri | http://repositorioslatinoamericanos.uchile.cl/handle/2250/1621305 | |
dc.description.abstract | Objectives. To compare the efficacy of three different standard chemotherapy regimens for low-risk gestational trophoblastic disease according to the FIGO staging system in a single-institute setting. Methods. From 1980 until 2002, we retrospectively reviewed 108 cases with low-risk persistent gestational trophoblastic disease who were treated with first-line chemotherapy. Patients were divided in three groups according to chemotherapy regimen: patients treated with methotrexate (MTX group; n=42), patients treated with dactinomycin (ACT group; n=42) and patients treated with methotrexate and dactinomycin in combination (MACT group; n=24). We compared the number of chemotherapy courses for achieving remission, the duration of treatment, the adverse side effects, the efficacy of the treatment and the need for performing a hysterectomy among the groups Results. The complete remission rates were 69%, 61.4% and 79.1% for methotrexate (MTX), dactinomycin (ACT) and the combination regimen (MACT) treated groups, respectively (p=0.7). The duration of the treatment and the number of chemotherapy courses were similar among the groups (p = 0.2 and p = 0.4, respectively). Adverse side effects rate was reported to be 62.5% in the MACT group, 28.6% in the MTX group and 19.1% in the ACT group (p=0.0003). Second-line chemotherapy was indicated for 30 patients. Hysterectomy was performed in 21 patients overall, and there was no difference among the groups (P=0.6). Conclusion. Our analysis indicates that single-agent chemotherapy regimens are as effective as combination chemotherapy for low-risk gestational trophoblastic disease. Dactinomycin is a less toxic drug and might offer the best cost-effective treatment option. Methotrexate must be considered as the regimen of choice for low resource areas because of the feasibility of its administration. (c) 2007 Elsevier Inc. All rights reserved. | |
dc.language | eng | |
dc.publisher | ACADEMIC PRESS INC ELSEVIER SCIENCE | |
dc.relation | Gynecologic Oncology | |
dc.rights | Copyright ACADEMIC PRESS INC ELSEVIER SCIENCE | |
dc.rights | restrictedAccess | |
dc.subject | human chorionic gonadotrophin | |
dc.subject | gestational trophoblastic disease | |
dc.subject | chemotherapy | |
dc.title | Treatment for low-risk gestational trophoblastic disease: Comparison of single-agent methotrexate, dactinomycin and combination regimens | |
dc.type | Artículos de revistas | |