Pulsed Actinomycin D for the Treatment of Low-risk Gestational Trophoblastic Neoplasia

  Objective  To investigate the efficacy and safety of pulsed Actinomycin D(Act-D) in the treatment of low-risk gestational trophoblastic neoplasia(LRGTN).

  Methods  Clinical data of 95 patients with LRGTN who were treated with pulsed Act-D biweekly in Peking Union Medical College Hospital from January 2012 to October 2015 were analyzed retrospectively.Efficacy in patients with different clinical features were analyzed with statistical analysis. Serum β-human chorionic gonadotropin(β-hCG) were measured in follow-up during chemotherapy to assess the efficacy. The severity of side effects was evaluated according to the United States National Cancer Institute-Common Terminology Criteria for Adverse Events (NCI-CTCAE).

  Results  Among the 95 patients, 79 (83.2%) achieved serum complete remission. Their chemotherapy courses ranged from 1 to 8 courses, with the mean of (4.4±1.3)courses. There was no statistically significant difference about the complete remission rate for the different clinical characteristics (P > 0.05). Sixteen patients changed regimen because of ineffectiveness or resistance, and achieved serum complete remission after combined chemotherapy. Severe side effects rate was 1.1 % (1/95). The mean duration of follow-up was (11.6±9.0) months. Three patients got recurrence, with the recurrence rate of 3.8%.

  Conclusions  Pulsed Act-D given biweekly was effective and well tolerated in patients with LRGTN. Because of its convenience, low cost, and good tolerance, it could be the choice of first-line chemotherapy for LRGTN.