低危妊娠滋养细胞瘤的巩固过程和复发率：一项MITO-9回顾性研究

IF 4.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Gynecologic oncology Pub Date : 2025-04-02 DOI:10.1016/j.ygyno.2025.03.033

Raffaella Cioffi , Robert Fruscio , Giulia Sabetta , Alice Bergamini , Cristina Dell'Oro , Giovanna Scarfone , Saverio Danese , Gennaro Cormio , Gabriella Ferrandina , Sandro Pignata , Giorgia Mangili

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引用次数: 0

摘要

目的甲氨蝶呤（MTX）是治疗妊娠滋养细胞瘤（GTN）的金标准药物。它被管理直到阴性人绒毛膜促性腺激素（hCG）水平，之后巩固课程建议。本研究的目的是评估巩固疗程数与复发率的关系。方法回顾性分析意大利1981年至2022年间接受一线MTX治疗的低风险GTN患者。排除标准为独家手术治疗，缺少疗程数数据或化疗耐药的非标准化定义。结果435例低危GTN患者中，333例符合条件。共有224例（67.2%）患者在接受一线MTX治疗后获得缓解。41例（17.4%）经历2个巩固疗程，无复发；132例（56.1%）接受3个巩固疗程，复发率2.2%；39例（16.5%）接受3个以上巩固疗程，复发率10.2%。95%接受2个巩固疗程的患者FIGO评分≤4分。多因素分析显示，0-2分患者的巩固疗程数与疾病复发无关。结论低危GTN的巩固疗程数对复发率无影响。我们的研究表明，FIGO评分为0、1和2的患者可以安全地接受2个巩固疗程。进一步的研究应探讨在得分较高的患者中适当的巩固疗程。

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Consolidation courses in low-risk gestational trophoblastic neoplasia and relapse rate: A MITO-9 retrospective study

Objective

Methotrexate (MTX) is the gold standard treatment for gestational trophoblastic neoplasia (GTN). It is administered until negative human chorionic gonadotropin (hCG) levels, after which consolidation courses are recommended. Aim of this study was to evaluate the relationship between number of consolidation courses and relapse rate.

Methods

Patients with low-risk GTN treated with first-line MTX between 1981 and 2022 in Italy were retrospectively identified. Exclusion criteria were exclusive surgical treatment, missing data on number of courses or non-standardized definitions of chemoresistance.

Results

Among 435 low-risk GTN patients, 333 were eligible. A total of 224 (67.2 %) patients achieved remission after treatment with first-line MTX. Forty-one patients (17.4 %) underwent 2 consolidation courses and had no relapse; 132 (56.1 %) received 3 consolidation courses with a relapse rate of 2.2 %; 39 patients (16.5 %) received more than 3 consolidation courses with a relapse rate of 10.2 %. Ninety-five percent of patients undergoing 2 consolidation courses had a FIGO score ≤ 4. Multivariate analysis showed that number of consolidation courses is not related to disease relapse in patients scoring 0–2.

Conclusions

Number of consolidation courses in low-risk GTN does not impact relapse rate. Our study demonstrates that patients with FIGO scores of 0,1 and 2 can safely receive 2 consolidation courses. Further studies should investigate the appropriate number of consolidation courses in patients with higher scores.

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来源期刊

Gynecologic oncology 医学-妇产科学

CiteScore

8.60

自引率

6.40%

发文量

1062

审稿时长

37 days

期刊介绍： Gynecologic Oncology, an international journal, is devoted to the publication of clinical and investigative articles that concern tumors of the female reproductive tract. Investigations relating to the etiology, diagnosis, and treatment of female cancers, as well as research from any of the disciplines related to this field of interest, are published. Research Areas Include: • Cell and molecular biology • Chemotherapy • Cytology • Endocrinology • Epidemiology • Genetics • Gynecologic surgery • Immunology • Pathology • Radiotherapy