Журнал крови и лимфы

Complete Remission of Choriocarcinoma with Primary Mtx Therapy and its Prevention using Mtx

Abstract

Kazuo Maeda

Aims: There were frequent hematogenous metastases ending with death due to brain metastasis in gestational choriocarcinoma (Ch-Ca) before methotrexate (MTX) therapy around 1960. As the gestational Ch-Ca was a systemic disease, it should be treated by systemic primary chemotherapy before local treatment. Methods: MTX was administered associating Actinomycin D, with intermittent or continuous regimen until the disappearance of Ch-Ca tumor and human chorionic gonadotropin (hCG). Results: Metastases, primary uterine focus, and hCG disappeared by the chemotherapy. Reproductive function recovered achieving normal uterine pregnancy after complete remission. Ch-Ca brain metastasis was treated by the MTX chemotherapy without recurrence for 20 years. Prevention of Ch-Ca: MTX was administered to 107 women after the complete hydatidiform mole until negative pregnancy test, where no Ch-Ca developed, while 6 Ch-Ca developed in 81 control cases of no MTX in 1968. An UICC RCT result was the same as above. However, 13 Ch-Cas were reported in 22 Japanese districts 2013, maybe no molar cyst was detected with B-mode image in early pregnancy, followed by no chemotherapy, but would be terminated as blighted ovum. The author calculated the number of estimated Ch-Ca cases to be 13, which was the same as actually reported number of Ch-Ca cases in 2013 and 2014.