Effects And Influenced Factors Of Primary Chemotherapy With Intravenous Infusion Of Methotrexate For Low-risk Gestational Trophoblastic Neoplasia

Objectives:To evaluate the efficacy of primary chemotherapy with intravenous infusion of methotrexate (MTX) for low-risk gestational trophoblastic neoplasia according to the FIGO staging system and to evaluate the influenced factors.Patients and methods:We retrospectively reviewed133cases with low-risk gestational trophoblastic neoplasia whose primary chemotherapies were intravenous (IV) MTX0.4mg/kg (maximum25mg) daily for5days every other week. Patients’ data between January2001and December2009was collected and the relationships of different factors and outcomes of chemotherapy were also evaluated.Results:One hundred of the133patients (75.2%) achieved complete primary remission and all patients achieved complete remission after salvage chemotherapy. Univariate analysis and Logistic regression analysis both showed that FIGO score and pre-treatment serum level of HCG were significantly associated with outcome of chemotherapy.10/20(50%) of low risk patients who scored FIGO5-6required salvage chemotherapy while compared to23/113(20.35%) patients scoring≤4. Conclusions:Primary chemotherapy with intravenous infusion of MTX may still be one of the options for patients with low risk GTN. The FIGO score and the pre-treatment serum level of HCG are independent risk factors of outcome of chemotherapy.