COSA 2014* Response to chemotherapy in patients with gestational trophoblastic neoplasia and subsequent fertility (#400)
Gestational Trophoblastic tumors are generally responsive to chemotherapy. Low risk disease is often cured with single-agent chemotherapy and high risk disease requires multiagent chemotherapy.
This study was undertaken to evaluate the response of gestational trophoblastic neoplasia to chemotherapy and future fertility.
A total of 33 gestational trophoblastic neoplasia treated at Kasturba Medical College Hospital, Manipal India, were followed up. The outcome in terms of response rate, recurrence, side effects and subsequent fertility were noted.
Out of 33, 21 (63.6%) belonged to low risk, 10 (30.3%) belonged to high risk and 2 (6%) were placental site trophoblastic tumors. All low risk patients received single agent (Methotrexate) regimen. High risk patients and one with placental site tumor (other lost for follow up) received multi agent (EMACO) regimen.
Out of 21 low risk patients 16 (76%) totally recovered, 2 (9%) has plateauing and 2 (9%) had recurrence and 1 (4.5%) had resistance to treatment. Out of 11 that received EMACO 10 (91%) recovered and 1 (9%) had plateauing. Those that had plateauing and resistance in low risk group responded after adding actinomycin and those that had recurrence were treated with EMACO. A total of 9 patients, 6 (28.5%) in single agent group and 3(23%) in EMACO group, conceived after the successful treatment. There were minimal side effects. One patient in EMACO group had premature menopause and one in Methotrexate group had hepatitis.
