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Gestational trophoblastic disease: does central nervous system chemoprophylaxis have a role?
Authors
A Althanassiou
A M Gillespie
+16Β more
AC Evans
B Du Beshter
B W Hancock
E Sheridan
EL Yordan
ES Newlands
GJS Rustin
JC Weed
JP Roberts
JT Soper
KC Brace
KD Bagshawe
N Siddiqui
PM Fisher
R E Coleman
WR Shapiro
Publication date
12 February 1999
Publisher
Nature Publishing Group
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on
PubMed
Abstract
In the UK there are standardized surveillance procedures for gestational trophoblastic disease. However, there are differences in practice between the two treatment centres in terms of definition of persistent gestational trophoblastic disease, prognostic risk assessment and chemotherapeutic regimens. The role of prophylactic chemotherapy for cerebral micrometastatic disease in persistent gestational trophoblastic disease is unclear. We have analysed the outcome of 69 patients with lung metastases who elsewhere might have received prophylactic intrathecal chemotherapy. Of the 69 patients, 67 received intravenous chemotherapy only. The other two patients had cerebral metastases at presentation. One patient who received only intravenous chemotherapy subsequently developed a cerebral metastasis, but this patient's initial treatment was compromised by non-compliance. This experience supports our current policy of not treating patients with pulmonary metastases, without clinical evidence of central nervous system (CNS) involvement, with prophylactic intrathecal therapy. Β© 1999 Cancer Research Campaig
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