Clinical Analysis Of 26 Cases Of Gestational Trophoblastic Tumors Treatment With The PVMM

OBJECTIVE:To evaluate the feasibility and efficacy of the PVMM regimen (cisplatin,etoposide,methotrexate,mifepristone)in the treatment of gestational trophoblastic neoplasia(GTN)METHODES:Twenty-six patients with gestational trophoblastic tumors were analyzed retrospectively.2 patients were chemorefractory and one was recurrent.All 26 patients were administrated with PVMM regimen,and 7 patients were assisted with surgery.All the patients were followed up.We investigated the number of chemotherapy courses for achieving remission,the duration of treatment,the adverse side effects,the efficacy of the treatment and the need for performing a hysterectomy.RESULTS:Twenty-six GTN patients underwent a total of 100 cycles of PVMM regimen.The average number of courses for each patient was 3.8.The total complete remission rate of the regimen was 96.2%(25/26).Thirteen patients with invasive mole received 46 cycles and the average number of courses was 3.5 and all achieved complete remission.Thirteen patients with choriocarcinoma received 54 cycles and the average number of courses was 4.2.The complete remission rate was 92.3% (12/13).Twenty-three patients received a total of 85 cycles and the average number of courses was 3.7.Twenty-two patients achieved complete remission and the other showed drug-resistant.The complete remission rate was 95.6%(22/23).Two patients with chemorefractory GTN obtained a total of 12 cycles and all achieved complete remission.One patient with recurrent GTN received 4 cycles and achieved complete remission.Bone marrow toxicity,gastrointestinal reaction and alopecia were the main side effects of the PVMM regimen,but the bone marrow toxicity was slight and no gradeâ…£side effect occurred.No fatal effect was found.Patients' acceptance and tolerance of adverse effects and ability to secure drug resources are factors contributing to the success of the treatment.19 patients preserved fertility function.CONCLUSION:Carboplatin,etoposide,methotrexate and mifepristone regimen is effective and safe for the treatment of matastatic trophoblastic neoplasms,including chemorefractory and recurrent GTN.