Comparison of Two Therapeutic Regimens: Methotrexate-Folinic Acid (۸ days) and Weekly Methotrexate in Patients with Low risk Gestational Trophoblastic neoplasia

Background: Methotrexate is used in the treatment of Low-risk Gestational Trophoblastic Neoplasia. The purpose of this study was to compare the therapeutic responses and side effects of two therapeutic methods which were prescribed for patients suffering from Low-risk Gestational Trophoblastic Neoplasia. One method was the daily use of Methotrexate-Folic Acid (for ۸ days) and the other was the weekly use of Methotrexate.Methods:This study is a randomized double-blind clinical trial which was undertaken on ۱۲۲ patients suffering from Low-risk Gestational Trophoblastic Neoplasia, who referred to AfzaliPoor Hospital in Kerman City, Iran. The patients were randomly divided into two groups: one group took Methotrexate-Folic Acid daily for a period of ۸ days (muscular taking of one milligram/kilogram of Methotrexate in days ۱,۳,۵ and ۷; and ۰.۱ milligram/kilogram of Folic Acid in days ۲,۴,۶ and ۸); the other group took the same medication weekly (muscular taking of ۳۰ to ۵۰ milligrams per each square meter of body mass every week).Results: Findings showed that ۹۵% of the patients effectively responded to the ۸-day regimen and ۹۰% responded to weekly regimen. Five percent of the ۸-day regimen group and ۱۰% of the weekly regimen group needed a second treatment. This difference was not significant. Concerning the related side effects, only one patient in the weekly regimen group experienced nausea and vomiting, and one patient experienced neutropenia; while ۴ patients in the ۸-day regimen group experienced nausea and vomiting, one patient had mucositis, ۲ patients had conjunctivitis, two patients experienced neutropenia, and one patient had thrombocytopenia.Conclusions: Considering the related costs, the ۸-day regimen was significantly more economical and affordable than the weekly regimen.

Keywords:

Folic acid , Gestational trophoblastic neoplasia , methotrexate