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ACTINOMYCIN D IN THE TREATMENT OF METHOTREXATE‐RESISTANT MALIGNANT TROPHOBLASTIC TUMOURS
Author(s) -
Ma H. K.,
Yip S. K.,
Chun Daphne
Publication year - 1971
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1971.tb00252.x
Subject(s) - methotrexate , chemotherapy , medicine , complete remission , disease , primary treatment , surgery , oncology , gastroenterology
Summary A series of 18 patients with methotrexate‐resistant trophoblastic tumours were treated with actinomycin D at the Queen Mary Hospital, Hong Kong, over a period of three years. Complete remission was attained with ten patients and eight died of the disease. The tumour response was better in patients with low gonadotrophin levels and was unaffected by the addition of 6‐mercaptopurine to the methotrexate. The prognosis was poor when the primary chemotherapy had been used for too long, or when certain organs or multiple sites were involved. Thus, of the nine patients who had received the primary chemotherapy for a period of only 6 to 12 weeks, seven went into complete remission; whereas, of the other nine patients who had received it for more than 12 weeks, only three went into complete remission. All patients with involvement of the brain or kidney or multiple sites died of the disease. Therefore the primary chemotherapy should be discontinued when continuous response is not observed during the first 6 to 12 weeks treatment. It is essential to make an early diagnosis of the resistant tumour which, however, depends chiefly on the availability of accurate gonadotrophin assays.