Combination chemotherapy for high-risk gestational trophoblastic tumour (GTT)

Deng L, Yan X, Zhang J, Wu T

Published Online:

July 7, 2010

Trophoblast cells take part in placenta formation following fertilisation and development of an embryo. GTT is a cancer that responds well to chemotherapy. Only one randomised controlled study comparing combination chemotherapy regimes was identified for this review. High quality randomised trials on combination chemotherapy for treating high risk GTT are not available and the best chemotherapy regimen is based on experience in trophoblastic centres only.

Abstract (click to read)

Background:

Gestational trophoblastic disease (GTD) includes gestational trophoblastic tumour and hydatidiform mole. Many women of reproductive age are affected by this disease although its incidence differs by geographical location. A number of chemotherapy regimens are used for treating the disease, such as methotrexate, actinomycin D and cyclophosphamide (MAC), methotrexate, actinomycin D, cyclophosphamide, doxorubicin, melphalan, hydroxyurea and vincristine (CHAMOC), etoposide, methotrexate and actinomycin (EMA) plus cyclophosphamide and vincristine (CO) (EMA-CO), etoposide, methotrexate and actinomycin (EMA) plus etoposide and cisplatin(EP) (EMA-EP). The efficacy of these drugs has not been systematically reviewed.

Objectives:

To determine the efficacy and safety of combination chemotherapy in treating high-risk GTT.

Search strategy:

Electronic searches of Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 2, 2008), MEDLINE, EMB and CBM, May 2008. Four journals were handsearched and other searching methods were used for identifying more studies.

Selection criteria:

The review included randomised controlled trials (RCTs) or quasi-RCTs of combination chemotherapy for treating high-risk GTT. Patients with placental-site trophoblastic tumour (PSTT), who had received chemotherapy in the previous two weeks, or patients with chemotherapy intolerance were excluded.

Data collection and analysis:

Two investigators independently collected data using a data extraction form. Meta-analysis was not performed and the review was conducted as a narrative review.

Main results:

One study with 42 participants was included in this review. It indicated that a MAC regimen was better than a CHAMOCA regimen for high-risk GTT because of lower toxicity. The quality of the study was unclear.

Authors' conclusions:

The methodological limitations of the included study prevent any firm conclusions about the best combination chemotherapy regimen for high-risk GTT. High quality studies are required.

This record should be cited as:

Deng L, Yan X, Zhang J, Wu T. Combination chemotherapy for high-risk gestational trophoblastic tumour. Cochrane Database of Systematic Reviews 2009, Issue 2. Art. No.: CD005196. DOI: 10.1002/14651858.CD005196.pub3

Assessed as up to date:

June 13, 2008

Find the research

Get full text at The Cochrane Library

Primary Review Group:

Gynaecological Cancer Group

Health topics:

Cancer > Gynaecological > Trophoblastic

Gynaecology > Cancer > Trophoblastic

Pregnancy & childbirth > Medical problems during pregnancy > Other

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

Combination chemotherapy for high-risk gestational trophoblastic tumour (GTT)

More like this

Copyright © 2012 - The Cochrane Collaboration