[Methotrexate combined chemotherapy for chemorefractory gestational trophoblastic tumour].

OBJECTIVE

To evaluate the response rate and toxicity of etopside, methotrexate, kengshengmycin, cyclophosphamide and vincristine (EMA/CO) regimen for women with chemorefractory gestational trophoblastic tumour.

METHODS

Fifty-one patients with chemorefractory gestational trophoblastic tumour were treated by EMA/CO regimen. Operative excision and (or) selective arterial infusion as adjuncts to chemotherapy were performed in a selected subset of patients. The response and toxicity were assessed after treatment.

RESULTS

Fifty-one patients received 352 cycles of the study regimen. The median number of courses for each patient was 6.9. Thirty-three cases (64.7%) achieved a complete remission while 14 patients (27.5%) had a partial remission, 4 cases showed nonresponse. Two (6.7%) of 30 complete responders developed recurrences. The main complications for EMA/CO chemotherapy were myelosuppression and gastrointestinal symptoms.

CONCLUSION

The EMA/CO regimen is an effective treatment for chemorefractory gestational trophoblastic tumour, and the chemotherapeutic results can be further improved while combined with arterial infusion chemotherapy and surgery in the selected patients.