ETOPOSIDE (VP-16) AS FIRST-LINE, SINGLE-AGENT CHEMOTHERAPEUTIC DRUG IN LOW-RISK GESTATIONAL TROPHOBLASTIC DISEASE

We reviewed the records of 73 patients with low-risk gestational troph oblastic disease (GTD) treated with etoposide from 1986 to 1995 at Chi ba University. All patients received courses of etoposide every 10 to 14 days until their human chorionic gonadotropin (hCG) concentrations had reached <1 mIU/ml or drug resistance and/or unacceptable toxicity occurred. Fifty-one patients (69.9%) were treated with chemotherapy al one and 22 patients (30.1%) also underwent planned hysterectomy. Sixty -seven patients (92%) achieved a primary remission, while six patients (8%) required a change in drugs due to drug resistance (4 patients, 5 %) or toxicity (2 patients, 3%). All 73 patients achieved complete rem ission. However, one patient (1.4%) relapsed later. We have demonstrat ed that etoposide is one of the most effective drugs against GTD and t hat the short-term toxicity is, except for alopecia, relatively mild a nd acceptable. Patients should, however, be informed of the possibilit ies of secondary malignancies and followed-up cautiously.