Weekly intramuscular methotrexate for nonmetastatic gestational trophoblastic disease

H. D. Homesley, J. A. Blessing, M. Rettenmaier, R. L. Capizzi, F. J. Major, L. B. Twiggs

Research output: Contribution to journalArticle

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Abstract

Patients with nonmetastatic gestational trophoblastic disease were entered into this Gynecologic Oncology Group study to determine the efficacy, toxicity, and cost-effectiveness of weekly intramuscular (IM) methotrexate. Treatment was initiated with 30 mg/m2 of weekly IM methotrexate. If no major toxicity was encountered, the weekly dose was escalated 5 mg/m2 at three-week intervals until a maximum dose of 50 mg/m2 each week was achieved. Complete response was defined as three normal β-hCG values measured on consecutive weeks. Fifty-one of 63 evaluable patients (81%) had a complete response to weekly IM methotrexate. Duration of therapy ranged from three to 19 weeks, with a median of seven. No major toxicity occurred. Thirteen patients experienced leukopenia at a median of 3300/μL, with a range of 2300-3900. Three patients had platelet nadirs of 66,000, 127,000 and 135,000/μL. Eleven patients with weekly IM methotrexate failure had a complete response after one to eight courses of dactinomycin administered 0.5 mg/m2 intravenously daily for five days; one refused therapy after three courses. Weekly IM methotrexate for nonmetastatic gestational trophoblastic disease is efficacious, minimally toxic, and cost-effective.

Original languageEnglish
Pages (from-to)413-418
Number of pages6
JournalObstetrics and Gynecology
Volume72
Issue number3 I
StatePublished - Jan 1 1988
Externally publishedYes

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Gestational Trophoblastic Disease
Methotrexate
Poisons
Leukopenia
Dactinomycin
Cost-Benefit Analysis
Reference Values
Therapeutics
Blood Platelets
Costs and Cost Analysis

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Homesley, H. D., Blessing, J. A., Rettenmaier, M., Capizzi, R. L., Major, F. J., & Twiggs, L. B. (1988). Weekly intramuscular methotrexate for nonmetastatic gestational trophoblastic disease. Obstetrics and Gynecology, 72(3 I), 413-418.

Weekly intramuscular methotrexate for nonmetastatic gestational trophoblastic disease. / Homesley, H. D.; Blessing, J. A.; Rettenmaier, M.; Capizzi, R. L.; Major, F. J.; Twiggs, L. B.

In: Obstetrics and Gynecology, Vol. 72, No. 3 I, 01.01.1988, p. 413-418.

Research output: Contribution to journalArticle

Homesley, HD, Blessing, JA, Rettenmaier, M, Capizzi, RL, Major, FJ & Twiggs, LB 1988, 'Weekly intramuscular methotrexate for nonmetastatic gestational trophoblastic disease', Obstetrics and Gynecology, vol. 72, no. 3 I, pp. 413-418.
Homesley HD, Blessing JA, Rettenmaier M, Capizzi RL, Major FJ, Twiggs LB. Weekly intramuscular methotrexate for nonmetastatic gestational trophoblastic disease. Obstetrics and Gynecology. 1988 Jan 1;72(3 I):413-418.
Homesley, H. D. ; Blessing, J. A. ; Rettenmaier, M. ; Capizzi, R. L. ; Major, F. J. ; Twiggs, L. B. / Weekly intramuscular methotrexate for nonmetastatic gestational trophoblastic disease. In: Obstetrics and Gynecology. 1988 ; Vol. 72, No. 3 I. pp. 413-418.
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