Author/Authors :
Ghasemian, Sedigheh Department of Obstetrics and Gynecology - School of Medicine - Urmia University of Medical Sciences, Urmia, Iran , Yousefi, Zohreh Department of Obstetrics and Gynecology - Fellowship of Gynecologist Oncologist - School of Medicine - Mashhad University of Medical Sciences, Mashhad, Iran , Farazestanian, Marjaneh Department of Obstetrics and Gynecology - School of Medicine - Mashhad University of Medical Sciences, Mashhad, Iran , Mousavi Seresht, Leila School of Medicine - Mashhad University of Medical Sciences, Mashhad, Iran , Foroughipour, Mohsen School of Medicine Mashhad University of Medical Sciences, Mashhad, Iran , Akhlaghi, Saeid School of Medicine - Mashhad University of Medical Sciences, Mashhad, Iran
Abstract :
Methotrexate as a single agent chemotherapy in most women with low risk gestational
trophoblastic neoplasia (GTN) has been associated with high treatment rate. Combination of
methotrexate with Vitamin A due to reduced number of chemotherapy regime courses is one
of the treatment options for patients with low-risk GTN. Therefore, this study was performed
with aim to determine the efficacy of combination therapy of Methotrexate with Vitamin A
in low risk GTN treatment. This randomized clinical trial was performed on 49 patients with
low risk gestational trophoblastic neoplasia. The treatment group (Group A = 19 cases) weekly
received Methotrexate 50 mg/m2, and Vitamin A 200000 IU, intra-muscular, and the control
group (Group B = 30 cases) only received Methotrexate 50 mg/m2 weekly. All patients were
followed up for 8 weeks. Then, treatment outcomes were compared between two groups, and
response to therapy was assessed in two groups by evaluation of HCG serum level. P < 0.05
was considered significant.Mean of B-HCG serum level after 4 weeks in Group A and Group B
was 68.5 mIu/mL and 360 mIu/mL, respectively (P = 0.018), and after 8 weeks was 1 mIu/mL
and 12 mIu/mL, respectively (P = 0.074). Combination therapy of Methotrexate and Vitamin A
in low risk GTN is associated with shorter duration of chemotherapy.
Keywords :
Combination therapy , B-HCG , Gestational Trophoblastic neoplasia (GTN) , Vitamin A , Methotrexate
