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What is your approach to first line systemic treatment for low risk gestational trophoblastic neoplasia?
Is there an optimal chemotherapy regimen that optimizes cure rates while minimizing side effects?
Answer from: at Community Practice
Patients with gestational trophoblastic disease and a WHO score < 6 are classified as low risk. In patients who desire retention of fertility, the first line treatment is chemotherapy which achieves typically very high remission rates/cure rates. The most frequently used first line regimens emplo...
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Answer from: at Community Practice
I use actinomycin D in patients with transportation issues (i.e., living out of town) since it is administered every two weeks. The remission rate is comparable to MTX.
These are remission data I found for low risk GTN treatment options:
Methotrexate - 1 mg/kg IM day 1, 3, 5, 7. Folinic acid 0.1...