Resistant Gestational Trophoblastic Neoplasia Patients Treated with 5-Fluouracil plus Actinomycin D

A combination of 5-fluorouracil plus actinomycin D (5FU plus Act D) is the regimen that has been commonlyadministered to Chinese and Japanese gestational trophoblastic neoplasia patients as the first or second lineof treatment with an excellent outcome. However, the efficacy of this regimen in a salvage setting was unclear.To evaluate the efficacy and safety of the 5 FU plus Act D regimen utilized in this condition, all GTN patientsresistant to at least three previous chemotherapy regimens who received the 5 FU plus Act D regimen betweenAugust 2009 and January 2011 at Chiang Mai University Hospital were reviewed. There were five cases whomet the criteria. Four of those patients were in FIGO stage III to IV with a WHO scoring of more than 12.The median number of cycles for each patient was two and only one case achieved remission while four of thecases were unresponsive. The toxicity was evaluated in 12 cycles. Common complications were uncomplicatedmyelosuppression and mucositis. In conclusion, this regimen revealed modest efficacy in a salvage setting withmanageable toxicity.