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In the treatment of chorionic tumor patients, the most difficult point for physicians and surgeons was to know when the chemotherapies should be finished. Many chorionic tumor patients in treatments were examined of daily urinary hCG radioimmunoassay using polymerized anti-hCG serum and the following patterns were discovered. i) Urinary hCG after delivery of hydatidiform mole usually dropped to LH level (150 IU/24 hrs) within 4 weeks, when patients received three successive intra uterine curettages with one week interval. ii) During or within 4 days after a course of chemotherapy, the temporary rises of urinary hCG were found in many cases ("Cellular Effect"). When the chemotherapies were discontinued eventhough the "Cellular Effect" was positive, the diseases were recurrent. iii) When daily assays of low titers of urinary hCG were carried out, the intermittent sharp rises of urinary hCG were found in some patients, though the hCG level were beeing kept in LH level. We call this phenomenon as "Intermittent Peak" and it was found that the recurrence did occur in patients with "Intermittent Peak" when the chemotherapies were discontinued. iv) In the course of hCG dropping by chemotherapies, the hCG titer showed large daily fluctuation. Thus, when the hCG titers dropped close to LH level, daily assay of low titer became necessary to prevent the errors. v) From the above findings, the remission of the disease must include, at least, the following conditions; a) the fall of urinary hCG to LH level, b) no cellular effect by chemotherapy, c) no hCG intermittent peak. Even the above three conditions could be seen in patients after treatments, further two courses of chemotherapies should be given. vi) Eventhough the urinary hCG did not drop to LH level over a long period of chemotherapies, therapy should be continued while the daily large fluctuation of hCG could be seen, because there were cases of hCG dropping to LH level in 10 months following repeated chemotherapies. (See pp. 1424,,,1435)

Urinary hCG Excretion Patterns of Chorionic Tumor Patients during and after Chemotherapies