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Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine 10/2008; 14(5 Suppl):43-6.
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ABSTRACT: Tam KF, Chan YM, Ng TY, Wong LC, Ngan HYS. Ethnicity is a factor to be considered before dose planning in ovarian cancer patients to be treated with topotecan. Int J Gynecol Cancer 2006;16:135–139.The objective of this study was to determine the efficacy and toxicity of topotecan in Chinese patients with ovarian cancer. A retrospective analysis on recurrent ovarian cancer patients receiving topotecan 1.25 mg/m2 daily for 5 consecutive days on a 21-day cycle from 1997 to 2002 was conducted. The patients included were all treated with at least two cycles of topotecan. The patient characteristics were compared in relation to their toxicity profile and their response to treatment. Response was evaluated by physical findings, imaging techniques, and serum CA125 level. A total of 60 patients were included in the study. All patients were evaluable for response and toxicities. A total of 361 cycles were given (median, 5 per patient; range 2–15). The major toxicity was neutropenia, which was grade 4 in 45.0% of the patients and 10.2% of the cycles. Age was the only covariate predicting the occurrence of grade 4 neutropenia (logistic regression P= 0.046, CI 1.01–1.12). Neutropenic fever occurred in 8.3% of the patients. Eighteen (30%) patients were required to delay their chemotherapy and 11 (18.3%) required dose reduction. Nonhematologic toxicities were mild. The overall response rate was 21.6%, with eight (13.3%) complete responses and five (8.3%) partial responses. The median duration of response and median time to progression were 11 and 5 months, respectively. The median survival was 14 months. Topotecan 1.25 mg/m2 in a five-times-daily schedule was well tolerated in a cohort of Chinese patients. Myelotoxicity was the most important side effect in our study, but the incidence is much lower than that reported in other studies. Age was an independent factor predicting the occurrence of grade 4 neutropenia.
International Journal of Gynecological Cancer 12/2005; 16(1):135 - 139. · 1.65 Impact Factor
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ABSTRACT: The aim of the study is to determine the predictors for seeking a second opinion and the utilization of complementary and alternative medicine (CAM) among gynecologic cancer patients.
Patients attending a gynecologic cancer clinic of a tertiary referral center were recruited over a period of 1 year. A survey was conducted for all the participants in a one-on-one basis.
One hundred ninety-one patients were recruited. Eighty patients (41.9%) had consulted other health-care professionals (HCP) for a second opinion after they were diagnosed to have cancer and 89 (46.6%) had utilized CAM. In multivariate analysis, late-stage disease (OR=2.65, 95% CI 1.26-5.58), treatment with radiotherapy (OR=2.27, 95% CI 1.19-4.33) and tertiary education (OR=11.28, 95% CI 3.06-41.54) were independent predictors for seeking a second opinion from other HCP and utilization of CAM. Patients who sought a second opinion from other HCP were more likely to utilize CAM (OR=6.12, 95% CI 3.24-11.54). Eighty percent of the patients did not inform their usual caregiver their utilization of CAM.
Seeking a second opinion from other HCP is common in gynecologic cancer patients. Patients who seek a second opinion are more likely to utilize CAM.
Supportive Care Cancer 10/2005; 13(9):679-84. · 2.60 Impact Factor
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ABSTRACT: To evaluate the effectiveness of psychological intervention in the care of cancer patients and to determine whether routine use of individual psychological therapies is indicated.
Patients with newly diagnosed gynecologic malignancies from August 1999 to November 2000 were recruited and randomly assigned to either a control group receiving routine medical care or to an intervention group receiving individual psychotherapy. A set of fixed-choice, self-report questionnaires assessing the patients' psychological status, quality of life, and their perceptions related to the medical consultations was completed at recruitment and then every 3 months for 18 months. Data analysis was performed according to the intention-to-treat principle by fitting the data into a linear mixed-effects model. Multivariable analyses were performed to examine the effects of confounding factors.
One hundred fifty-five patients participated in the trial. There were no statistically significant differences between the two groups at baseline. There was a trend toward better quality of life and functional status and also improvement of the symptoms over time for both groups. No differences were found between the groups in the scores measured by any of the instruments at baseline and at any time points after the cancer diagnosis. Psychological intervention had no significant effects on the psychosocial parameters.
Routine use of psychological therapies as given in our format has no significant effect on the patients' quality of life and psychological status.
Journal of Clinical Oncology 09/2005; 23(22):4913-24. · 18.37 Impact Factor
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ABSTRACT: Intrinsic radiosensitivity using the clonogenic assay and the cell surviving fraction at 2 Gy (SF2) has been shown to be an independent prognostic factor for patient response to radiotherapy in carcinoma of the cervix. The clonogenic assay has significant shortcomings, making it unsuitable for routine clinical use. The ATP cell viability assay (ATP-CVA) has been shown to have a high tumor evaluability rate, technical simplicity, and reproducibility in chemosensitivity testing.
This study compares the ATP-CVA with the clonogenic assay in the in vitro radiosensitivity testing of cervical cancer cell lines. Correlation of in vitro radiosensitivity and in vivo patient response was also determined.
Five cervical carcinoma cell lines (SiHa, HeLa, Caski, C-33A, and C4-1) were tested using the ATP-CVA and the clonogenic assay. Survival curves were plotted and the mean SF2 values obtained by the two different assay methods were compared using ANOVA to see if there were significant differences. Mean SF2 values obtained from 27 cervical cancers were compared with clinical outcomes.
The SF2 values for the cell lines ranged from 0.28 to 0.67 when tested using the ATP-CVA. Using the clonogenic assay, the SF2 values ranged from 0.27 to 0.70. ANOVA with Bonferroni pairwise multiple comparison showed no significant difference between the mean SF2 values for the individual cell lines between the two assay methods. Twenty-three cervical cancer samples (85%) were evaluable for SF2 using ATP-CVA. The mean SF2 values of patients who had locoregional failure were significantly higher than those who achieved local control (P <0.01).
Testing intrinsic radiosensitivity using the surviving fraction at 2 Gy (SF2) is comparable using the two assay methods of ATP-CVA and clonogenic assay. The ATP-CVA should be further investigated in the testing of intrinsic radiosensitivity in patients with cervical cancer.
Gynecologic Oncology 03/2005; 96(3):765-70. · 3.89 Impact Factor
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ABSTRACT: To investigate the effects of precolposcopy counseling on women's anxiety, knowledge about colposcopy and compliance to follow-up.
Two hundred and twenty women referred for colposcopy for the first time were recruited. They attended precolposcopy sessions in which written and video information were given and subsequently were randomized to have either further explanation and discussion with an experienced colposcopic nurse (study group) or no further discussion (control group). Each subject completed a Chinese version of the state-anxiety questionnaire (STAI) and a knowledge questionnaire before and immediately after the precolposcopy sessions and also before the colposcopy examination. Women's concern and opinion on the programme were also assessed. Follow-up data was compared with those who did not attend the precolposcopy sessions.
Women's knowledge about colposcopy significantly improved after the precolposcopy sessions. The improvement was more significant in the study group than in the control group immediately after the sessions (P = 0.003). The difference between the groups in knowledge scores remained statistically significant before colposcopic examination (P = 0.015) but the difference diminished between these two assessment points. There was no statistically significant difference between the two groups in the anxiety scores at all assessment points. Women who attended the precolposcopy sessions had a significantly higher attendance rates and better compliance to follow-up than those who did not attend the sessions.
Precolposcopy session with explanation and discussion improves women's knowledge about colposcopy, but has negligible effects on women's anxiety before colposcopy. Provision of written and video information at the precolposcopy sessions can improve compliance to follow-up after colposcopy.
Gynecologic Oncology 12/2004; 95(2):341-6. · 3.89 Impact Factor
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ABSTRACT: This study aimed to investigate the prevalence of human immunodeficiency virus (HIV) infection in women with cervical cancer and to decide whether HIV testing should be included as part of the initial work-up of invasive cervical cancer.
This was a prospective case controlled study. Women with newly diagnosed cervical cancer were tested and age-matched women with benign gynecologic conditions were selected as control. Serum samples were tested for HIV I and HIV II antibodies at diagnosis and 3 months later.
Two hundred twenty-five consecutive patients with newly diagnosed cervical cancer and two hundred twenty-three age-matched women with benign gynaecological conditions were tested. In comparison with the control, women with cervical cancer started sexual intercourse at an earlier age and had a statistically significant higher number of sexual partners. All the HIV tests were negative. The HIV prevalence rate was estimated to be 0.0-1.6% for both groups.
HIV screening should not be a part of the initial work-up for cervical cancer in a population with a low background prevalence.
Gynecologic Oncology 02/2004; 92(1):300-3. · 3.89 Impact Factor
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ABSTRACT: The FIGO Committee Report on the FIGO 2000 staging for gestational trophoblastic disease included criteria for the diagnosis of gestational trophoblastic neoplasia (GTN). It recommended investigative tools for diagnosing metastases. Anatomical and prognostic indicators were combined into a stage : risk score to stratify patients into low and high-risk groups. This is the first staging system to incorporate inclusive criteria that are likely to be adopted universally. The diagnostic evaluation of GTN is presented. The rationale of using the various investigative tools is discussed. The problem of measuring human chorionic gonadotrophin (hCG) levels using commercial kits and the phenomenon of 'phantom hCG' is explored. The use of single agent chemotherapy for low-risk disease versus multi-agent chemotherapy for high-risk disease is discussed. Controversies regarding when to stop chemotherapy are explored with a view to minimizing the short and long-term toxicity, in particular the small risk of developing a second malignancy. Recommendations for the follow up of patients after chemotherapy with particular reference to contraceptive advice and future pregnancies are discussed in the light of current evidence.
Bailliè re s Best Practice and Research in Clinical Obstetrics and Gynaecology 01/2004; 17(6):893-903. · 1.73 Impact Factor
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ABSTRACT: The Bethesda system for reporting cervicovaginal cytologic diagnoses was recently revised in 2001. Pathologists are required to report not only whether the smear favors neoplastic changes, but also the origin of the abnormal cells. In this study, archival smears were reviewed to evaluate the usefulness of the new classification.
Smears having atypical glandular cells taken between January 1995 and December 1997 were reviewed and subclassified according to the revised Bethesda classification. Case records were then reviewed and cases with discrepancies between the cytological evaluation and corresponding final histological diagnoses were further reviewed.
There were 138 smears reviewed. The mean age of the patients was 47 (range, 18 to 78). Thirty-four smears favored neoplasia and 104 favored "NOS" ("not otherwise specified"). Sixty smears favored endocervical origin and 78 endometrial origin. Forty-three patients (31%) had significant pathologies, including 12 (8.7%) patients with high-grade CIN, 2 (1.4%) with low-grade CIN, 5 (3.6%) with HPV infection, 7 (5.1%) with carcinoma of the corpus, 1 (0.7%) with cervical adenocarcinoma in situ, 4 (2.9%) with adenocarcinoma of the cervix, 3 (2.2%) with endometrial hyperplasia, and 5 (3.6%) with carcinoma of the ovary. Two (1.4%) patients had double primary female genital malignancies and 2 patients (1.4%) had extragenital malignancies. Significant correlation was found between smears "favor neoplasia" and a final diagnosis with significant pathology (chi(2) test, P < 0.05). Significant association was found between AGC favored endocervical origin and a final diagnosis with cervical diseases (chi(2) test, P < 0.05). Four of the 43 patients who had significant pathologies had lesions found during their subsequent visits and all of them had cervical smears classified as AGC "favor neoplasia".
AGC found on cervical smears are an indication for early and intensive investigation.
Gynecologic Oncology 12/2003; 91(3):603-7. · 3.89 Impact Factor
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ABSTRACT: The goal of this work was to investigate the impact of music on women's anxiety and perceived pain during colposcopy examination.
This was a prospective randomized study. Two hundred and twenty women referred for colposcopy for the first time were recruited. They were randomized to either the music or no-music group. Before colposcopy examination, each subject completed a Chinese version of the state anxiety questionnaire (STAI) and assessed the anticipated pain for colposcopy with a visual analog scale (VAS). Slow-rhythm music was played during colposcopy examination in the music group. Subjects in the no-music group were examined in the same setting without music. After colposcopy, each subject completed the STAI form again and assessed their pain during examination by the VAS.
Women in the music group experienced significantly less pain (mean VAS 3.32 [95% CI 2.86-3.78] vs 5.03 [4.54-5.52], P<0.001) and lower anxiety (mean STAI 39.36 [95% CI 37.33-41.39] vs 44.16 [41.82-46.49], P = 0.002) during colposcopy examination than women in the no-music group. On linear regression analysis, the factors significantly affecting anxiety during colposcopy were anxiety score at enrollment, pain score during colposcopy, and whether or not the women had listened to music during the colposcopy examination. The factors significantly affecting the pain scores were whether the women had listened to music during the procedure and the final anxiety scores.
Music is a simple, inexpensive, and easily used strategy to minimize anxiety and pain during colposcopy examination.
Gynecologic Oncology 10/2003; 91(1):213-7. · 3.89 Impact Factor
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ABSTRACT: The purpose was to explore whether health education on symptoms of ovarian cancer would aid in early detection, by examining the relationship between symptoms, coping strategies, and timing of presentation in patients with newly diagnosed ovarian cancer.
Eighty women were included. A questionnaire consisting of a series of open questions was designed to collect information on the sequence of events from the onset of symptoms to the diagnosis of ovarian cancer. The Coping Response Inventory (CRI) was used to assess the coping strategies.
A majority (90.0%) of women with ovarian cancer did have symptoms before the diagnosis. Abdominal pain or discomfort, abdominal distension, a palpable abdominal mass, menstrual, bowel, or urinary symptoms were the commonly reported symptoms. Eight (10.0%) patients were totally asymptomatic prior to the cancer diagnosis. The presence of bowel symptoms was significantly associated with late stage disease. Most of the patients sought medical advice within 2 weeks from the onset of symptoms. There was no association between the presence of any particular symptom(s) and the timing of presentation. There was also no correlation between the coping strategies and stage of disease and timing of presentation. On average, patients with early stage disease saw one more doctor compared to patients with late stage disease before the affirmative diagnosis of ovarian cancer.
Most patients presented early after the onset of symptoms. Health education in this regard may not be useful for early diagnosis of ovarian cancer.
Gynecologic Oncology 10/2003; 90(3):651-6. · 3.89 Impact Factor
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ABSTRACT: To investigate the occurrence of somatic mitochondrial DNA (mtDNA) mutations in human primary endometrial carcinomas, we sequenced the D-loop region, the 12S and 16S rRNA genes of mtDNA of cancer tissues and their matched normal controls. About 56% (28 out of 50) of cases carry one or more somatic changes in mtDNA including deletion, point mutation and mitochondrial microsatellite instability (mtMSI), namely the change in length of short base-repetitive sequences of mtDNA. In particular, mtMSI was frequently detected in 89% (25 out of 28) of all the cases carrying somatic changes followed by point mutations (25%; seven out of 28) and deletion (3.5%; one out of 28). The CCCCCTCCCC sequences located in the Hypervariable Regions I and II of the D-loop and 12S rRNA gene are instability hot spot regions in endometrial carcinomas. It is suggested that errors in replication may account for the high frequency of mtMSI in human endometrial carcinomas. The relatively high prevalence of mtMSI may be a potential new tool for detection of endometrial cancer.
British Journal of Cancer 09/2003; 89(4):697-701. · 5.04 Impact Factor
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ABSTRACT: A previous study showed E-cadherin expression was lost in some cervical cancer cell lines and tumours. This study was designed to clarify the significance of DNA methylation in silencing E-cadherin expression. We examined promoter methylation of E-cadherin in five cervical cancer cell lines and 20 cervical cancer tissues using methylation-specific PCR (MSP) and bisulphite DNA sequencing. The correlation of E-cadherin methylation and expression together with methyltransferase (DNMT1) were further studied. We found that hypermethylation of E-cadherin was involved in five cervical cancer cell lines and 40% (8/20) of cervical cancer tissues. E-cadherin protein was lost in 6/8 (75%) samples and 3/5 (60%) cell lines with promoter methylation. E-cadherin methylation was significantly correlated with increased DNMT1. Using an antisense DNMT1 oligo to transfect into SiHa HeLa C33A cell line, E-cadherin protein was re-expressed. We concluded that loss of E-cadherin expression was in part correlated with DNA methylation and DNMT1 expression in cervical cancer.
European Journal of Cancer 04/2003; 39(4):517-23. · 5.54 Impact Factor
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ABSTRACT: The purpose was to examine the outcomes of patients with advanced ovarian cancer treated with neoadjuvant chemotherapy, with a special emphasis on the patients' quality of life (QOL).
Seventeen patients with advanced ovarian cancer were treated with neoadjuvant chemotherapy based on the extent of disease on computer tomography. All patients received combined platinum/paclitaxel chemotherapy. Debulking surgery was performed after three cycles or six cycles of chemotherapy, depending on the response to the chemotherapy. Patients' QOL was studied over time using European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 and was then compared with that of patients treated with conventional treatment in the previous cohort.
The response rate to chemotherapy assessed at three cycles was 82.4%. The rate of optimum debulking to residual disease less than 2 cm after chemotherapy was 76.9%, and 38.5% had no gross residual disease after surgery. The median overall survival was 22.9 months. The median disease-free interval was 13.3 months. The overall QOL improved after chemotherapy and this continued to improve up to 12 months. The other functional scales also showed improvements over time, apart from the initial transient deterioration in the role functioning and cognitive functioning at 3 months after chemotherapy. Patients treated with neoadjuvant chemotherapy seem to have better but statistically insignificant difference in QOL parameters than patients treated conventionally.
Neoadjuvant chemotherapy is an alternative treatment for patients with advanced ovarian cancer in whom the chance of optimal cytoreduction is low. The patients' overall quality of life and functional status improve after neoadjuvant chemotherapy.
Gynecologic Oncology 02/2003; 88(1):9-16. · 3.89 Impact Factor
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ABSTRACT: A retrospective analysis of clinical data extracted from hospital records of 145 patients who had had primary surgical treatment for endometrial cancer in Queen Mary Hospital, Hong Kong, from 1987 to 1993 was performed to study the prognostic significance of positive peritoneal cytology. Positive peritoneal cytology was found to be associated with poor prognostic factors such as deep myometrial invasion, high grade tumor, extrauterine spread and lymphovascular permeation. By univariate analysis, all the poor prognostic factors were found to be significant in affecting survival. These included age above 65, nonadenocarcinoma histology, deep myometrial invasion, positive cytology, extrauterine involvement and lymphovascular involvement. By multivariate analysis, only histology and extrauterine involvement remained significant. In patients with positive cytology, 61.1% had extrauterine involvement at initial presentation. Patients who had positive cytology and extrauterine disease had the shortest survival. The survival was independent of cytology result when the tumor was confined to the uterus.
International Journal of Gynecological Cancer 02/2002; 6(6):473 - 476. · 1.65 Impact Factor
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ABSTRACT: The aim of this study was to assess the cost-effectiveness of serial squamous cell carcinoma antigen (SCC) monitoring in the clinical setting.
All patients with squamous cell carcinoma of the cervix and SCC measurement from 1994 to 1999 were reviewed. The cost of the investigations, including blood tests, X rays, and computer tomography; and clinic visits were adjusted to 2001 dollars for all cases over the 6-year study period. The effectiveness measure was the number of cases detected by SCC monitoring before the onset of clinical symptoms or abnormal physical examination findings. Altered clinical management due to early detection was considered successful.
Two thousand eight hundred fifty-one SCC antigen assays were performed from 384 patients. An elevated pretreatment SCC level was associated with poorer cumulative survival over time (P < 0.05). Fifty-five patients had recurrences, with 10 local and 45 distant recurrences. SCC levels were elevated in 47 patients (85%). The median lead time was 7.8 months. The cost of finding 1 recurrence was US$4750. SCC monitoring does not alter clinical management and has no advantage over clinical examination in detecting local recurrence. Most of the recurrent diseases were detected too late for curative treatment. Only 1 patient, in whom the diagnosis could have been made by clinical examination without SCC monitoring, may have potentially benefited from exenteration.
Posttreatment SCC monitoring is not cost-effective in the absence of curative treatment for distant spread of disease.
Gynecologic Oncology 01/2002; 84(1):7-11. · 3.89 Impact Factor
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ABSTRACT: The objective was to describe the pattern of quality of life (QOL) over time and to assess the impact of age, symptoms, disease parameters, and treatment on the overall QOL.
A longitudinal study on patients with newly diagnosed gynecologic cancer using individual patients as their own control was performed. The 33-item EORTC QLQ-C30(+3) was used as the QOL measure. Patients were assessed before treatment, after completion of treatment, and at 6, 12, and 24 months. Spearman's correlation analyses were performed. A mixed effect model was fitted to the data. Bonferroni pairwise comparisons were used to analyze the different variables.
One hundred forty-four women completed the study. Overall QOL improved after the completion of treatment but remained the same throughout the 2 years after treatment. The individual patient's QOL before treatment was insignificant while the impact of treatment on the individual patient was significant in determining QOL after treatment. There was a strong correlation for all time points in most factors, indicating that the global health status, functional scales, and symptom scales exhibit a dependent change over time. Relief in symptoms was associated with improvements in functional scales. The scores on overall QOL were lower for younger patients and for patients treated with chemotherapy than for patients treated with surgery.
Strategies for supportive care need to focus on symptom management. Psychosocial interventions, to be effective, should include all patients and should aim to reduce the impact of treatment on the individual patient.
Gynecologic Oncology 11/2001; 83(1):10-9. · 3.89 Impact Factor
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ABSTRACT: The aim of this study was to investigate the feasibility of using DNA in the circulation as a diagnostic tool for cervical cancer.
We used PCR followed by Southern hybridization to detect human papillomavirus (HPV) DNA in serum samples taken from patients of cervical cancer before treatment.
A total of 60 samples were analyzed. In a set of 40 samples, without knowledge of the HPV DNA status in the corresponding cervical carcinomas, we could detect 8 (20%) positive samples, of which 7 (17.5%) were HPV 16 and 1 (2.5%) was HPV 18. In another set of 20 samples, known to be HPV 16 infected in the corresponding cervical carcinomas, we detected only 4 (20%) HPV-16-positive samples. The occurrence of HPV DNA in sera of cervical cancer patients seems sporadic.
The low incidence indicates that serum HPV DNA has limited application in the diagnosis of cervical cancer.
Gynecologic Oncology 09/2001; 82(2):269-72. · 3.89 Impact Factor
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ABSTRACT: The inhibitor of apoptosis proteins (IAP) suppress apoptosis induced by a variety of stimuli. The aims of this study were to: (a) compare the expression of X-linked IAP (Xiap) and Human IAP-2 (Hiap-2) in cervical carcinoma cells and normal cervix, (b) determine the correlation between IAP expression and tumour apoptosis or proliferation, and (c) assess their prognostic significance in cervical carcinomas. Paraffin-embedded tissue sections were retrieved from 77 patients with cervical squamous carcinomas prior to treatments and 47 normal subjects. Tumour apoptosis was determined by terminal deoxynucleotidyl transferase (TdT)-mediated deoxyuracil triphosphate (dUTP) nick-end labelling (TUNEL) and apoptotic index (AI), and the proliferative rate was measured by Ki-67 and mitotic (MI) indices. Immunoreactive Xiap and Hiap-2 were found in both cervical cancer cells and normal tissues. IAP expressions in cancers did not correlate with apoptotic and proliferative parameters, disease stage and patient survival. The lower AI and Ki-67 index were associated with a better survival. In conclusion, the basal expression levels of IAPs have no prognostic significance, but AI and Ki-67 expression are potential prognostic indicators in cervical carcinoma.
European Journal of Cancer 07/2001; 37(9):1104-10. · 5.54 Impact Factor
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ABSTRACT: The current study attempts to evaluate the effectiveness of methotrexate infusion therapy in the management of low-risk gestational trophoblastic disease and to find out whether an increase in the dose intensity can effect a faster remission and a shorter treatment duration.
This is a prospective study. Between June 1990 and August 1998, 59 patients with low-risk trophoblastic disease were treated with methotrexate at a dose of 100 mg/m(2) as an intravenous bolus over 30 minutes followed by a 12-hour infusion of methotrexate at a dose of 200 mg/m(2). Folinic acid was not given unless the serum methotrexate reached a toxic level 24 hours after infusion (toxic level, 10 micromol/L). Actinomycin D was added in patients with a partial response. The follow-up period of these patients ranged from 12 to 113 months, with a median of 58.5 months and a mean of 55.7 months.
Fifty-four patients attained a complete biochemical remission. Twenty-eight patients went into biochemical remission after one methotrexate infusion. Five patients showed a partial biochemical response. A relapse developed in 2 of the 54 complete responders at 3 months and 18 months after the initial therapy. Both patients received combination therapy consisting of methotrexate, etoposide, and bleomycin. They went into biochemical remission and have remained disease-free at the time of analysis. All of the 59 patients were in biochemical remission at the time of analysis. No significant side effects were observed except that Stevens-Johnson syndrome developed in 1 patient.
Methotrexate infusion therapy described in this study is effective in the treatment of low-risk gestational trophoblastic disease. The omission of consolidation therapy and folinic acid rescue decreases the cost and duration of treatment.
American Journal of Obstetrics and Gynecology 01/2001; 183(6):1579-82. · 3.47 Impact Factor
