Leila Mousavi - assistant profesor, fellowship of gynecology oncology, obstetric and gynecology department, isfahan medical scienceof school, isfahan, iran
Malihe Hasanzadeh Mofrad - profesor, fellowship of gynecology oncology, obstetric and gynecology department, mashhad medical science ofschool, mashhad, iran
Fatemeh Homaie Shandiz - profesor, radio oncology department, mashhad medical science of school, mashhad, iran

Background and Aim : : High risk gestational trophoblastic neoplasia is considered a treatable malignancydue to recent advancements in chemotherapy. This report describes treatment outcomes as a predictor ofprognosis in one instituteMethods : : We performed a retrospective analysis of the treatment results from 41 patients diagnosed withhigh risk and metastatic gestational trophoblastic neoplasia who received treatment at Mashhad Universityof Medical Sciences, Mashhad, Iran from January, 2008 to May, 2014.Results : : Patients had a mean age of 31.31 years. Average treatment time was 3.5 months. Within theparticipants; 19 patients with World Health Organization scores over 7; received methotrexate at the firstline of treatment. 11 cases(26.8%) of the 19 patients with single agent chemotherapy showed resistance.The patients who were resistant to treatment received a combination chemotherapy as the second line oftreatment. The response rate of the etoposide, methotrexate, actinomycin D, cyclophosphamide and oncovinchemotherapy regimen as the first line of treatment was 93.7%, which decreased to approximately 83.3%when administered asthe second line of treatment. There were 76.4% of cases in remission at the one yearfollow-up and a successful pregnancy rate of 17.5%.Astatistically significant relation existed betweenchemotherapy response rate with disease stage, score, site, and number of metastases (P<0.05).Conclusion : TheWorld Health Organization/International Federation of Gynecology and Obstetricsstaging-scoring system is appropriate for gestational trophoblastic neoplasia management. The etoposide,methotrexate, actinomycin D, cyclophosphamide, and oncovin regimen showed superior efficacy. Theimportance of accurate patient selection for adjuvant surgery in high risk gestational trophoblastic neoplasiacannot be emphasized.

Gestational trophoblastic disease, Drug therapy, Prognosis