Platinum preparations in the treatment of trophoblastic tumors
https://doi.org/10.17650/1994-4098-2010-0-4-112-117
Abstract
The N.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, has developed and used new polychemotherapy regimens including platinum preparations for the treatment of patients with trophoblastic tumors. A cysplatin + ethoposide or carboplatin + ethoposide (CyE/CaE) combination was used as second-line chemotherapy in methotrexate-resistant locally advanced form (Stages I-II) of the disease. A cysplatin or carboplatin + methotrexate + dactinomycin + vincristine) (CyMDV/CaMDV) regimen was used as first-line therapy in patients with disseminated (Stage III-IV) disease and as second-line therapy in patients with its resistant form (Stages III-IV). The CyE/CaE regimen could cure 21 patients with Stages I-II without surgical intervention. When the CyMDV/CaMDV regimen was used as first-line therapy in 24 patients with Stages III-IV disease, of them 21 (87.5%) patients achieved a complete therapeutic effect, they all have been survivors to the present time. The CyMDV/CaMDV regimen used as second-line chemotherapy in patients with the resistant form turned out to be effective in 5 (83.3%) of 6 cases. The follow-up lasted > 3 years.
The benefit of the developed regimens including platinum preparations is that they are effective, less toxic, require long hospitalization and are technically simpler, which allows them to be used in the outpatient setting of the wide oncological network.
About the Authors
I. V. Markina
N.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, Moscow; Department of Oncology, Faculty of Postgraduate Education, Moscow State University of Medicine and Dentistry
Russian Federation
Russian Federation
B. O. Toloknov
N.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, Moscow; Department of Oncology, Faculty of Postgraduate Education, Moscow State University of Medicine and Dentistry
Russian Federation
Russian Federation
L. V. Manzyuk
N.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, Moscow; Department of Oncology, Faculty of Postgraduate Education, Moscow State University of Medicine and Dentistry
Russian Federation
Russian Federation
E. E. Makhova
N.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, Moscow; Department of Oncology, Faculty of Postgraduate Education, Moscow State University of Medicine and Dentistry
Russian Federation
Russian Federation
N. G. Kormosh
N.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, Moscow; Department of Oncology, Faculty of Postgraduate Education, Moscow State University of Medicine and Dentistry
Russian Federation
Russian Federation
References
1. Новикова Л.А., Григорова Т.М. Хорионэпителиома матки: клиника и лечение. Л.: Медицина, 1968.
2. Толокнов Б.О., Махова Е.Е., Лактионов К.П. и др. Хориокарцинома матки (классификация, диагностика, лечение, прогноз). М.: URSS, 2000.
3. Онкогинекологический атлас. Классификация и определение стадии опухолей и принципы диагностики и лечения. Под ред. Дж. Р. Смита, Д. Хили. М.: Практическая медицина, 2010.
4. Краткое руководство по лечению опухолевых заболеваний. Под ред. М.М. Боядзиса, П.Ф. Лебоуица. М.: Практическая медицина, 2009.
5. Berkowitz R.S., Kohorn E.I., Goldstein D.P., Fisher R.A. Advances in the management of gestational trophoblastic disease: presentations from the XIIIth World Congress on Gestational Trophoblastic Disease. Journal Reprod Med 2006;(10).
6. Толокнов Б.О., Махова Е.Е., Мартышина Я.А., Шмаков Г.С. Возможности излечения и сохранения детородной функции у больных хориокарциномой матки. В сб.: Материалы V российского форума «Мать и дитя». Тезисы докладов. М., 2003.
7. Yang J.-J., Xiang Y., Wan X., Yang X.-Y. Prognosis of malignant gestational trophoblastic neoplasia – 20 years of experience. J Reprod Med 2008;53:600–7.
8. Lurain J.R. Management of high-risk gestational trophoblastic disease. J Reprod Med 1998;43:44–52.
9. Newlands E.S., Bower M., Rustin J.S. Management of resistant gestational trophoblastic tumors. J Reprod Med 1998;43:111–8.
10. Evans A.C. Jr., Soper J.T., Clarke- Pearson D.L. et al. Gestational trophoblastic disease metastatic to the central nervous system. Gynecol. Oncol. 1995; 59 (2): 226–230.
11. Hextan Y.S., Ngan M.D., Karen K.L. et al. Chan relapsed gestational trophoblastic neoplasia: a 20-year experience. J Reproduct Med 2006;51:829–34.
12. Fülöp V., Szigetvi I., Szepesi J. et al. Diagnosis and treatment of high-risk metastatic gestational trophoblastic neoplasia in Hungary. J Reprod Med 2008;53(7):541–6.
13. Toloknov B., Makhova E., Laktionov K. Platinum compounds in the treatment at patients with uterus choriocarcinoma. Intern J Gynecol Cancer 2003;13(Suppl 1).
14. Мещеряков А.А. Лечение резистентных трофобластических опухолей. Практ онкол 2008;9(3):171–8.
15. Bagshawe K.D. Gynecologic oncology 1995; Trophoblastic tumors: diagnostic hiethods, epidemiology, clinical features and management: 1027–1043.
16. Piamsomboon S., Kudelka A.P., Termrungruanglert W. et al. Remission of refractory gestational trophoblastic disease in the brain with ifosfamide, carboplatin, and etoposide (ICE): first report and review of literature. Eur J Gynecol Oncol 1997; 18 (6): 453–456.
Review
For citations:
Markina I.V., Toloknov B.O., Manzyuk L.V., Makhova E.E., Kormosh N.G. Platinum preparations in the treatment of trophoblastic tumors. Tumors of female reproductive system. 2010;(4):112-117. (In Russ.) https://doi.org/10.17650/1994-4098-2010-0-4-112-117
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