Regression pattern of alpha fetoprotein level changed after treatment of malignant germ cell tumor.

OBJECTIVE: To identify the regression pattern of serum alpha fetoprotein in malignant germ cell tumors after initial chemotherapy MATERIAL AND METHOD: This was a retrospective descriptive study. All patients with malignant germ cell tumor who had elevated serum alpha fetoprotein (AFP) and received adjuvant chemotherapy in Rajavithi Hospital between January 1984 and May 2007 were included. RESULTS: Sixty patients with malignant germ cell tumor that met the study criteria were included. The median progression free interval (PFI) was 64.3 months and the median overall survival (OS) was 70.9 months. Four courses of chemotherapy was the average. AFP was first negative after a mean of course of three. Two more cycles were given as a maintenance course. The regression of AFP, between its level before the first and second courses was less than 0.015, associated with survival, accuracy about 70%, sensitivity 83.3%. The number of maintenance courses of chemotherapy was statistically affected to PFI and OS (p-value of 0.025, 0.003, respectively). CONCLUSION: The regression of AFP is an independent prognostic factor in malignant germ cell tumor and may be a useful tool in the therapeutic management of these patients.

Comparison of low-dose monophasic oral contraceptive pills and expectant management in treatment of functional ovarian cysts.

OBJECTIVE: To compare the effectiveness of low-dose monophasic oral contraceptive pills in the treatment of spontaneously occurring functional ovarian cyst detected by ultrasonography compared with expectant management. MATERIAL AND METHOD: A total of 70 women in their reproductive period with functional ovarian cysts detected by means of ultrasonography were randomized to low-dose monophasic Oral Contraceptive pills (OC) or to expectant management and followed up at one month with a second ultrasonography. If the ovarian cysts were still present, the women were followed for another month while on the same treatment. RESULTS: At the first month, the remission rates of ovarian cyst were 63.6% in low-dose monophasic OC and 52.9% in expectant groups. At the second month, the cumulative remission rates increased up to 72.7% in low-dose monophasic OC and 67.6% in expectant groups. There was no statistically significant difference between the two groups at both the first and second month of treatment. The most common side effect in women using OC was acne (18%). CONCLUSION: Low-dose monophasic OC were no more effective than expectant management in the treatment of spontaneously occurring functional ovarian cysts.