By Ed Susman Special to DG News LOS ANGELES, CA — May 9, 2002 —
A one-day treatment with methotrexate — as opposed to treatments over several days — is effective in treating women with low-risk gestational trophoblastic tumors. “We saw a 100 percent success rate in returning the hormone marker for this disease to normal in our patient population,” said Dr. Jayanthi Lea, MD, of the University of Texas Southwestern Medical School at Dallas. She reported the findings here Wednesday at the 50th Annual Clinical Meeting of the American College of Obstetricians and Gynecologists (ACOG).Dr. Lea said the one-day treatment is helpful because multiple-cycle treatments do not take into account patient noncompliance, especially in indigent women. In a retrospective study that covered 10 years at Parkland Memorial Hospital, Dallas, Dr. Lea identified patients with elevated beta-human chorionic gonadotropin (b-HCG).
The women were identified in postmaternity examinations, where their b-HCG levels averaged more than 400,000 mIU/mL. A level of less than 5 mIU/mL — the limit of delectability of the testing assay — is normal, she said. The researchers assessed the patients to determine whether the high b-HCG levels were due to placental residue. For patients with b-HCG levels not elevated by placental residue, the researchers assumed the problem was a trophoblastic tumor, usually in the form of invasive moles. These women were then treated with dilation and curettage (D&C). If b-HCG levels failed to decline to normal after D&C, the patient was evaluated for chemotherapy or hysterectomy.
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