Single-dose methotrexate regimen in the treatment of low-risk gestational trophoblastic neoplasia.

Abstract

The objective of the study was to evaluate the effectiveness of single-dose methotrexate in women with low-risk gestational trophoblastic neoplasia. In this prospective observational cohort study, 105 women with low-risk gestational trophoblastic neoplasia were treated with an intravenous bolus of 100 mg/m2 of methotrexate followed by a 12-hour infusion of 200 mg/m2. If the human chorionic gonadotropin level fell 10-fold after 2 weeks, no further chemotherapy was given. Characteristics between the 2 groups with or without complete remission with this regimen were compared. The overall complete remission rate with methotrexate was 84.8%, with 44.8% of women requiring a single dose of methotrexate alone. The pretreatment human chorionic gonadotropin level was found to be significantly higher in women who failed the single-dose methotrexate regimen (P = .001), and 10 of 11 patients with metastases required further doses. This regimen offers an effective option for women with low-risk gestational trophoblastic neoplasia without metastases and a low pretreatment human chorionic gonadotropin level.