Mono and polichemotherapy in the treatment of metastatic and invasive gestational trophoblastic disease: analysis of 50 cases

RESUMO

Fifty patients with metastatic or invasive gestational trophoblastic disease (GTD) were admited at the "Hospital das clínicas" of the Ribeiräo Preto School of Medicine of the Säo Paulo University between January 1980 and December 1990. Of these 50 patients, 44 (88 per cent) had GTD folliwing abortion, 5 (10 per cent) after term pregnancies and one (2 per cent) after an ectopic pregnancy. Thirty five (70 per cent) had invasive GTD and 15 (30 per cent) metastatic GTD). The sites of metastases were: lung, 8 (53.3 per cent), pelvis, 4 (26,6 per cent), central nervous system, 2 (13.3 per cent) and right auricle, 1 (6.6 per cent). Human chorionic gonadotropin, pelvic arteriography and ultrasonography were used in the diagnosis of invasive GTD. 25 of the 41 patients with low-risk metastatic and invasive GTD were treated with monochemotherapy. There were 6 (24 per cent failures and the remining 19 patients (76 per cents had complete remission of the disease after 3.89 meancycles. Sixteen patients were treated with polichemotherapy, there were 2 (12.5 per cent) failure and the remaining 14 had complete remission after a 2.3 mean cycles. No statistical differences between the two types of chemotherapy were observed. Four (8 per cent)deaths were recorded