5 – day Actinomycin D regimen in the treatment of Methotrexate - resistant low - risk Gestational Trophoblastic Disease
Vol. 19 No. 4 (2021), Original Articles

Vol. 19 No. 4 (2021)

5 – day Actinomycin D regimen in the treatment of Methotrexate - resistant low - risk Gestational Trophoblastic Disease

Original Articles
10.46755/vjog.2021.4.1305
Published March 7, 2022
10.46755/vjog.2021.4.1305
Ha Bao Van Nguyen
National Hospital of Obstetrics and Gynecology
https://orcid.org/0000-0002-4086-0801
Van Thang Nguyen
National Hospital of Obstetrics and Gynecology
Thi Thu Huong Le
National Hospital of Obstetrics and Gynecology
Thi Hao Doan
National Hospital of Obstetrics and Gynecology
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Nguyen, H. B. V., Nguyen, V. T., Le, T. T. H., & Doan, T. H. (2022). 5 – day Actinomycin D regimen in the treatment of Methotrexate - resistant low - risk Gestational Trophoblastic Disease. Vietnam Journal of Obstetrics & Gynecology, 19(4), 29-34. https://doi.org/10.46755/vjog.2021.4.1305
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Abstract

Objectives: Clinical and subclinical characteristics of a group of patients with MTX-resistant low-risk gestational trophoblastic disease treated with a 5-day ActinomycinD (ACTD) monotherapy regimen.
Subjects and methods: 40 patients with MTX-resistant low-risk gestational trophoblastic disease treated with ACTD for 5 days at the National Hospital of Obstetrics and Gynecology from January 2019 to October 2021.

Methods: A retrospective descriptive cross-sectional study without a control based on the medical records of the National Hospital of Obstetrics and Gynecology.

Results: The overall success rate was 85%, especially in the group of patients with pretreatment βhCG concentration ≤ 300IU/l, the cure rate reached 91.2% with p=0.033. The difference is statistically significant with OR=10.33. 95% CI: 1.44-75.69. The FIGO score at the time of diagnosis also contributes to the prognosis of treatment response. From 0 to 2 points, there are no drug-resistant patients. The recovery ability of the group with the FIGO score from 0 to 2 points was 1.46 times greater than that of the group of patients with 3 or more points. The difference was statistically significant with p=0.001. There are 4 main adverse effects (ADRs) are vomiting, stomatitis, leukopenia, elevated liver enzymes.

Conclusions: The 5-day actinomycin D is an effective and safe regimen in the treatment of Methotrexate-resistant low risk gestational trophoblastic patients with βhCG levels ≤ 300 IU/l and FIGO score from 0-2 points

Keywords

low - risk gestational trophoblastic disease, Actinomycin D
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