ABSTRACT
The objective of this study was to identify the regression pattern of serum beta-hCG in persistent trophoblastic disease patients after initiating chemotherapy. Eighty-nine women who were diagnosed as persistent trophoblastic disease in King Chulalongkorn Memorial Hospital between January 1985 and December 1998, and received single agent chemotherapy were included. The incidence was 20.2 per cent of total gestational trophoblastic disease patients. Seventy-two (80.9%) from 89 patients were recruited in our study. Sixty-four (88.9%) patients responded to first-line chemotherapy and 8 patients (11.1%) resisted. Suction curettage was done as initial treatment in 61 (84.7%) cases. Most of them (95.8%) received actinomycin-D as first line treatment. Total courses of chemotherapy averaged 4 courses, but increased to 8.5 courses in the resistant group. Mean time of serum beta-hCG to remission was 16.7 and 21.5 weeks in the chemo-sensitive and chemo-resistant group, respectively. Average time to start chemotherapy was in the tenth week, and in the resistant group it was started in the sixth week. Chemotherapy regimen was changed in the fifteenth week. Initial serum beta-hCG levels were not significantly different between the two groups. The reduction rates of beta-hCG were significantly different from the third to the seventh week in the chemo-sensitive and chemo-resistant groups, which was during the second and third course of chemotherapy (P<0.05). In conclusion, by using the reduction rate, the regression pattern of serum beta-hCG level in persistent trophoblastic disease patients was significantly different between the chemosensitive and chemoresistant group from the third to the seventh week after starting chemotherapy.