Low-risk gestational trophoblastic neoplasia: A single-center experience from Saudi Arabia

Objective: To report our single-center experience in terms of patient clinical characteristics, treatment outcomes, and chemotherapy-related toxicities in patients with low-risk gestational trophoblastic neoplasia (GTN). Materials and Methods: A retrospective cross-sectional study (2008–2013) was co...

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Autores principales:	Abdulaziz Alobaid, Samer Ahmeed, Mohammed Abuzaid, Latifa Aldakhil, Ahmed Abu-Zaid
Formato:	article
Lenguaje:	EN
Publicado:	Thieme Medical and Scientific Publishers Pvt. Ltd. 2019
Materias:	actinomycin d gestational trophoblastic neoplasia methotrexate saudi arabia Medicine R
Acceso en línea:	https://doaj.org/article/7eaf4a2cb57f4f4baad0fbc396f1c61c
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spelling	oai:doaj.org-article:7eaf4a2cb57f4f4baad0fbc396f1c61c2021-12-02T17:05:51ZLow-risk gestational trophoblastic neoplasia: A single-center experience from Saudi Arabia2231-07702249-446410.4103/ajm.AJM_188_18https://doaj.org/article/7eaf4a2cb57f4f4baad0fbc396f1c61c2019-07-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.4103/ajm.AJM_188_18https://doaj.org/toc/2231-0770https://doaj.org/toc/2249-4464Objective: To report our single-center experience in terms of patient clinical characteristics, treatment outcomes, and chemotherapy-related toxicities in patients with low-risk gestational trophoblastic neoplasia (GTN). Materials and Methods: A retrospective cross-sectional study (2008–2013) was conducted at a tertiary health-care hospital in Saudi Arabia. Forty-four (n = 44) patients met the inclusion criteria for low-risk GTN. Methotrexate (MTX) was administered in a 5-day regimen: 0.3–0.5mg/kg intravenously (IV) daily for 5 days every 2 weeks (maximum 25mg per dose). Actinomycin D (ActD) was administered 1.25mg/m2 pulsed IV every 2 weeks. Results: The majority of patients had molar pregnancy as the antecedent event (86%), developed GTN within the first 4 months after the initial evacuation (93.2%), had human chorionic gonadotropin levels between 1,000 and 10,000 mIU/dL (36.3%), and had the World Health Organization prognostic scores from 0 to 2 (48.7%). Only 38 patients accepted treatment with chemotherapy. A total of 37 patients received first-line MTX; 34 patients of them achieved complete remission (CR, 92%). The three patients who developed MTX resistance were salvaged with sequential ActD and all achieved CR of 100%. Only one patient received first-line ActD and achieved CR. The overall survival as well as cure rate for all patients with low-risk GTN was 100%. No patient developed MTX-related hepatic toxicity or ActD-related blister formation. No severe adverse effects occurred. Conclusion: Our 5-day IV MTX regimen was highly effective in treating patients with low-risk GTN, with CR rate of 92% and no severe toxicity. Primary and sequential ActD therapy appears to be very effective.Abdulaziz AlobaidSamer AhmeedMohammed AbuzaidLatifa AldakhilAhmed Abu-ZaidThieme Medical and Scientific Publishers Pvt. Ltd.articleactinomycin dgestational trophoblastic neoplasiamethotrexatesaudi arabiaMedicineRENAvicenna Journal of Medicine, Vol 9, Iss 03, Pp 89-93 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	actinomycin d gestational trophoblastic neoplasia methotrexate saudi arabia Medicine R
spellingShingle	actinomycin d gestational trophoblastic neoplasia methotrexate saudi arabia Medicine R Abdulaziz Alobaid Samer Ahmeed Mohammed Abuzaid Latifa Aldakhil Ahmed Abu-Zaid Low-risk gestational trophoblastic neoplasia: A single-center experience from Saudi Arabia
description	Objective: To report our single-center experience in terms of patient clinical characteristics, treatment outcomes, and chemotherapy-related toxicities in patients with low-risk gestational trophoblastic neoplasia (GTN). Materials and Methods: A retrospective cross-sectional study (2008–2013) was conducted at a tertiary health-care hospital in Saudi Arabia. Forty-four (n = 44) patients met the inclusion criteria for low-risk GTN. Methotrexate (MTX) was administered in a 5-day regimen: 0.3–0.5mg/kg intravenously (IV) daily for 5 days every 2 weeks (maximum 25mg per dose). Actinomycin D (ActD) was administered 1.25mg/m2 pulsed IV every 2 weeks. Results: The majority of patients had molar pregnancy as the antecedent event (86%), developed GTN within the first 4 months after the initial evacuation (93.2%), had human chorionic gonadotropin levels between 1,000 and 10,000 mIU/dL (36.3%), and had the World Health Organization prognostic scores from 0 to 2 (48.7%). Only 38 patients accepted treatment with chemotherapy. A total of 37 patients received first-line MTX; 34 patients of them achieved complete remission (CR, 92%). The three patients who developed MTX resistance were salvaged with sequential ActD and all achieved CR of 100%. Only one patient received first-line ActD and achieved CR. The overall survival as well as cure rate for all patients with low-risk GTN was 100%. No patient developed MTX-related hepatic toxicity or ActD-related blister formation. No severe adverse effects occurred. Conclusion: Our 5-day IV MTX regimen was highly effective in treating patients with low-risk GTN, with CR rate of 92% and no severe toxicity. Primary and sequential ActD therapy appears to be very effective.
format	article
author	Abdulaziz Alobaid Samer Ahmeed Mohammed Abuzaid Latifa Aldakhil Ahmed Abu-Zaid
author_facet	Abdulaziz Alobaid Samer Ahmeed Mohammed Abuzaid Latifa Aldakhil Ahmed Abu-Zaid
author_sort	Abdulaziz Alobaid
title	Low-risk gestational trophoblastic neoplasia: A single-center experience from Saudi Arabia
title_short	Low-risk gestational trophoblastic neoplasia: A single-center experience from Saudi Arabia
title_full	Low-risk gestational trophoblastic neoplasia: A single-center experience from Saudi Arabia
title_fullStr	Low-risk gestational trophoblastic neoplasia: A single-center experience from Saudi Arabia
title_full_unstemmed	Low-risk gestational trophoblastic neoplasia: A single-center experience from Saudi Arabia
title_sort	low-risk gestational trophoblastic neoplasia: a single-center experience from saudi arabia
publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
publishDate	2019
url	https://doaj.org/article/7eaf4a2cb57f4f4baad0fbc396f1c61c
work_keys_str_mv	AT abdulazizalobaid lowriskgestationaltrophoblasticneoplasiaasinglecenterexperiencefromsaudiarabia AT samerahmeed lowriskgestationaltrophoblasticneoplasiaasinglecenterexperiencefromsaudiarabia AT mohammedabuzaid lowriskgestationaltrophoblasticneoplasiaasinglecenterexperiencefromsaudiarabia AT latifaaldakhil lowriskgestationaltrophoblasticneoplasiaasinglecenterexperiencefromsaudiarabia AT ahmedabuzaid lowriskgestationaltrophoblasticneoplasiaasinglecenterexperiencefromsaudiarabia
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Low-risk gestational trophoblastic neoplasia: A single-center experience from Saudi Arabia

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