Alternating weekly chemotherapy with etoposide-methotrexate-dactinomycin/cyclophosphamide-vincristine for high-risk gestational trophoblastic disease.

Abstract:

OBJECTIVE:To evaluate the response rate and toxicity of alternating weekly therapy with etoposide-methotrexate-dactinomycin/cyclophosphamide-vincristine for women with high-risk gestational trophoblastic disease. METHODS:Twenty-two women with gestational trophoblastic disease received 126 cycles of the study regimen. Response was evaluated by serial hCG monitoring. Toxicity was assessed using standard criteria. RESULTS:Six women (27%) were treated for primary therapy and 16 (73%) for secondary therapy. The median prognostic index score was 11 (range 7-19). Only 23% of the patients and 11% of the 126 treatment cycles had grade 4 neutropenia, despite the heavily pretreated patient population. Only 2% of the cycles were associated with neutropenic sepsis or required platelet transfusions. Nonhematologic toxicity was modest. Among 16 women who received chemotherapy alone, there were 11 (69%) complete and three (19%) partial responses. When adjuvant therapies are included, the overall complete and partial response rates were 77 and 14%, respectively. Six (35%) of 17 complete responders developed recurrences. Five patients with partial response or relapse were salvaged with additional therapy. Fifteen of the 22 patients (68%) have sustained remissions. CONCLUSION:The regimen of alternating weekly etoposide-methotrexate-dactinomycin/cyclophosphamide-vincristine is effective and well-tolerated chemotherapy for patients with high-risk gestational trophoblastic disease.

journal_name

Obstet Gynecol

authors

Soper JT,Evans AC,Clarke-Pearson DL,Berchuck A,Rodriguez G,Hammond CB

subject

Has Abstract

pub_date

1994-01-01 00:00:00

pages

113-7

issue

1

eissn

0029-7844

issn

1873-233X

journal_volume

83

pub_type

杂志文章
  • Measurement of breast volume by ultrasound during normal menstrual cycles and with oral contraceptive use.

    abstract::The volume of the human breast was measured by ultrasonographic methods with good reliability and reproducibility. Variations in breast volume of up to 36% were encountered with weekly measurements during the course of seven normal menstrual cycles. Oral contraceptives containing 35 to 50 micrograms ethynyl estradiol ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Malini S,Smith EO,Goldzieher JW

    更新日期:1985-10-01 00:00:00

  • Maternal and Fetal Risk Associated With Assisted Reproductive Technology.

    abstract::Infertility is a disease that affects up to 15.5% of reproductive-aged couples. Until the birth of the first neonate born from in vitro fertilization (IVF) in 1978, many infertile couples did not have an opportunity to conceive a biological child. Over the past 40 years, access to and effectiveness of IVF have increas...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/AOG.0000000000002786

    authors: Kawwass JF,Badell ML

    更新日期:2018-09-01 00:00:00

  • Revisiting the fetal loss rate after second-trimester genetic amniocentesis: a single center's 16-year experience.

    abstract:OBJECTIVE:To estimate an institution's specific fetal loss rate after a second-trimester genetic amniocentesis. METHODS:This is a retrospective cohort study using our prenatal diagnosis database for all pregnant women presenting for care between 1990 and 2006. We compared the fetal loss rate in women who underwent amn...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0b013e318162eb53

    authors: Odibo AO,Gray DL,Dicke JM,Stamilio DM,Macones GA,Crane JP

    更新日期:2008-03-01 00:00:00

  • Implementation of the "Pregnancy Reasonably Excluded Guide" for Pregnancy Assessment: A Quality Initiative in Outpatient Gynecologic Surgery.

    abstract:OBJECTIVE:Preoperative evaluation for pregnancy at our institution lacked standardization among individual health care providers and surgical services. This pilot project aimed to improve assessment for pregnancy before scheduled outpatient gynecologic surgical procedures. The Pregnancy Reasonably Excluded Guide incorp...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0000000000002917

    authors: Wyatt MA,Ainsworth AJ,DeJong SR,Cope AG,Long ME

    更新日期:2018-11-01 00:00:00

  • Ultrasound-detected subchorionic hemorrhage and the obstetric implications.

    abstract:OBJECTIVE:To estimate the association between the ultrasonographic diagnosis of subchorionic hemorrhage and adverse pregnancy outcomes. METHODS:This was a retrospective cohort study of all consecutive women undergoing routine ultrasonography before 22 weeks with a singleton gestation at one institution from 1994 to 20...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0b013e3181e90170

    authors: Norman SM,Odibo AO,Macones GA,Dicke JM,Crane JP,Cahill AG

    更新日期:2010-08-01 00:00:00

  • Some thoughts on assessing the effectiveness of passive immunization to Rh.

    abstract::In 1000 Rh-negative women who are delivered of Rh-positive fetuses and receive passive immunity postpartum, there will be 5-10 failures to protect against sensitization. Studies have been conducted to find out possible explanations for the failures and to devise means of preventing some or all of them. Results from ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Johnson JS,Clayton EM Jr

    更新日期:1974-04-01 00:00:00

  • Discrepancy in the interpretation of cervical histology by gynecologic pathologists.

    abstract:OBJECTIVE:To determine if subspecialty review of cervical histology improves diagnostic consensus of cervical intraepithelial neoplasia (CIN). METHODS:After routine histologic assessment within the hospital pathology department, 119 colposcopic cervical biopsies were interpreted by two subspecialty-trained gynecologic...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/s0029-7844(02)02058-6

    authors: Parker MF,Zahn CM,Vogel KM,Olsen CH,Miyazawa K,O'Connor DM

    更新日期:2002-08-01 00:00:00

  • Dual-Force Vaginoplasty for Treatment of Segmental Vaginal Aplasia.

    abstract:BACKGROUND:Vaginal aplasia occurs in 1 in 5,000-10,000 female live births. In this report, we evaluated a novel dual-force vaginoplasty technique for treatment of 11 patients with segmental vaginal aplasia. TECHNIQUE:The principle of the approach is to thin the atretic part between two counteracting forces. The instru...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0000000000001974

    authors: El Saman AM,Farag MA,Shazly SA,Noor M,Ali MK,Othman ER,Khalifa M,Farghly TA,El Saman DA

    更新日期:2017-05-01 00:00:00

  • Transcutaneous electrical nerve stimulation (TENS) for the treatment of primary dysmenorrhea: a randomized crossover comparison with placebo TENS and ibuprofen.

    abstract::In a randomized four-way crossover study, 32 women with primary dysmenorrhea were treated with transcutaneous electrical nerve stimulation (TENS) for two cycles, placebo (sham) TENS for one cycle, or ibuprofen 400 mg four times a day for one cycle. The TENS setting used was 100 pulses per second with 100-microsecond p...

    journal_title:Obstetrics and gynecology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Dawood MY,Ramos J

    更新日期:1990-04-01 00:00:00

  • Pregnancy outcome in recurrent miscarriage patients with skewed X chromosome inactivation.

    abstract:OBJECTIVE:To analyze X inactivation in women with recurrent miscarriage to estimate whether skewed X inactivation is associated with recurrent miscarriage and whether it predicts next pregnancy outcomes. METHODS:A multicenter study was performed. A power calculation determined that 101 patients were needed to detect a...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章,多中心研究

    doi:10.1016/s0029-7844(03)00345-4

    authors: Sullivan AE,Lewis T,Stephenson M,Odem R,Schreiber J,Ober C,Branch DW

    更新日期:2003-06-01 00:00:00

  • Clinical applications of cell-free fetal DNA from maternal plasma.

    abstract:OBJECTIVE:To describe our clinical experience with detection and analysis of cell-free fetal DNA derived from maternal plasma for prenatal sexing and fetal rhesus-D typing. METHODS:Real-time quantitative polymerase chain reactions (PCRs) of rhesus-D sequences and the SRY gene were validated and offered to patients wit...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/01.AOG.0000103996.44503.F1

    authors: Rijnders RJ,Christiaens GC,Bossers B,van der Smagt JJ,van der Schoot CE,de Haas M

    更新日期:2004-01-01 00:00:00

  • Pulsion enterocele: long-term results of an abdominoperineal technique.

    abstract::Surgical correction of large pulsion enterocele is a contentious subject and until a technique is founded upon proper anatomic facts, the arguments will continue. Pulsion enterocele follows changes in the pelvic cellular tissues and levator ani complex; both defects must be corrected. Synchronous abdominoperineal repa...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Zacharin RF,Hamilton NT

    更新日期:1980-02-01 00:00:00

  • A simple visual assessment technique to discriminate between menorrhagia and normal menstrual blood loss.

    abstract:OBJECTIVE:To validate a simple, highly predictive test to discriminate between menorrhagia and normal menstrual blood loss. METHODS:The sanitary wear of 489 menstrual bleeding episodes was collected by 288 women for objective measurement of menstrual blood loss (alkaline hematin method); the women made a subjective as...

    journal_title:Obstetrics and gynecology

    pub_type: 临床试验,杂志文章

    doi:10.1016/0029-7844(95)00062-V

    authors: Janssen CA,Scholten PC,Heintz AP

    更新日期:1995-06-01 00:00:00

  • Primary invasive carcinoma of the vagina.

    abstract::A retrospective study of 29 patients with invasive carcinoma of the vagina was completed at The Milton S. Hershey Medical Center, Pennsylvania State University, for a ten-year period from 1976-1986. The overall incidence was 1.3% of all gynecologic malignancies. Twenty-four patients (83%) had squamous cell carcinoma a...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Manetta A,Pinto JL,Larson JE,Stevens CW Jr,Pinto JS,Podczaski ES

    更新日期:1988-07-01 00:00:00

  • Remote hemodynamics and renal function in formerly preeclamptic women.

    abstract:OBJECTIVE:Women with a history of preeclampsia have an increased risk of developing chronic hypertension and cardiovascular disease. However, little is known about the mechanism responsible for vascular disease in formerly preeclamptic women. The aim of our study was to test whether preeclampsia predisposes to central ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0b013e31819caf0f

    authors: Spaan JJ,Ekhart T,Spaanderman MEA,Peeters LLH

    更新日期:2009-04-01 00:00:00

  • Antecedent history as a predictor of surgical cure of urgency symptoms in mixed incontinence.

    abstract:OBJECTIVE:To determine the cure rate of urge incontinence after Burch colposuspension in patients with mixed incontinence diagnosed urodynamically, to determine if cure rates were different when the onset of urge symptoms antedated or postdated the symptoms of stress incontinence, and to propose appropriate preoperativ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/s0029-7844(97)00550-4

    authors: Scotti RJ,Angell G,Flora R,Greston WM

    更新日期:1998-01-01 00:00:00

  • Acute appendicitis in pregnancy and the occurrence of major intraventricular hemorrhage and periventricular leukomalacia.

    abstract:BACKGROUND:Infection and endotoxemia have been associated with neurologic injury in the newborn. In addition, recent reports have noted an increased incidence of fetal neurologic injury in the presence of intrauterine infection. CASES:Three pregnancies complicated by acute appendicitis and refractory preterm labor res...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/0029-7844(95)00211-9

    authors: Mays J,Verma U,Klein S,Tejani N

    更新日期:1995-10-01 00:00:00

  • National Trends and Reported Risk Factors Among Pregnant Women With Syphilis in the United States, 2012-2016.

    abstract:OBJECTIVE:To describe recent syphilis trends among pregnant women and to evaluate the prevalence of reported high-risk behaviors in this population. METHODS:We analyzed U.S. national case report data for 2012-2016 to assess trends among pregnant women with all stages of syphilis. Risk behavior data collected through c...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0000000000003000

    authors: Trivedi S,Williams C,Torrone E,Kidd S

    更新日期:2019-01-01 00:00:00

  • Impact of increased access to emergency contraceptive pills: a randomized controlled trial.

    abstract:OBJECTIVE:To assess how a strategy to maximize access to emergency contraceptive pills would affect rates of pregnancy and sexually transmitted infections. METHODS:Sexually active women, 14-24 years old, were randomly assigned to two methods of access to emergency contraceptive pills: increased access (two packages of...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/01.AOG.0000235708.91572.db

    authors: Raymond EG,Stewart F,Weaver M,Monteith C,Van Der Pol B

    更新日期:2006-11-01 00:00:00

  • Hormones, mood, and cognitive functioning in postmenopausal women.

    abstract::Findings from basic neuroscience have provided information on the effects of estrogen on brain morphology and chemistry that explain how this sex steroid may influence brain function. The clinical literature shows that estrogen enhances mood and specific aspects of cognitive functioning in postmenopausal women. There ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/0029-7844(95)00431-9

    authors: Sherwin BB

    更新日期:1996-02-01 00:00:00

  • An instrument for the recovery of preimplantation uterine ova.

    abstract::This report describes an instrument to recover fertilized ova from the human uterus without anesthesia. Two hundred sixty-five lavages were performed on 20 normal and presumed fertile women and on seven infertile women. Using 60 mL of fluid, median fluid recovery was 97% (range 65-100%). In the fertile women, ova were...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Sauer MV,Bustillo M,Gorrill MJ,Louw JA,Marshall JR,Buster JE

    更新日期:1988-05-01 00:00:00

  • Rapid B-scan (real-time) ultrasonography in the identification and evaluation of twin pregnancies.

    abstract::Real-time ultrasonography utilizing a hand-held linear array transducer provides a highly accurate method of identifying and evaluating the twin gestation. The rapidity of real-time scanning eliminates interpretational problems caused by fetal movements. Additionally, the versatility of transducer positioning facilita...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Levine SC,Filly RA

    更新日期:1978-02-01 00:00:00

  • Twice a cesarean, always a cesarean?

    abstract::The cesarean delivery rate has quadrupled during the past two decades, resulting in considerable attention focused on alternatives to cesarean birth. One option, vaginal birth after one previous cesarean, has come to be recognized as an acceptable alternative to routine elective repeat cesarean delivery. The purpose o...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Phelan JP,Ahn MO,Diaz F,Brar HS,Rodriguez MH

    更新日期:1989-02-01 00:00:00

  • Uterine leiomyomas in pregnancy: a prospective study.

    abstract::Uterine leiomyomas are associated with various complications during pregnancy. During a 2-year period, pregnant women with a history of leiomyomas were referred to our antenatal testing unit for ultrasound evaluation. Eighty-five patients were found to have single or multiple leiomyomas by ultrasound examination. The ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Davis JL,Ray-Mazumder S,Hobel CJ,Baley K,Sassoon D

    更新日期:1990-01-01 00:00:00

  • Ultrasonic assessment of fetal response to second-trimester amniocentesis.

    abstract::Twenty-three patients undergoing second-trimester amniocentesis were ultrasonically monitored for 30 minutes before and 30 minutes after the amniocentesis. Fetal movements were recorded as movements of limbs, trunk, or combined limb-trunk movements. Fetal heart rates were determined at ten-minute intervals before and ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Gianopoulos J,Elias SS,Simpson JL,Tamura R

    更新日期:1986-03-01 00:00:00

  • Doppler fetal echocardiography in endocardial fibroelastosis.

    abstract:BACKGROUND:Endocardial fibroelastosis is a congenital heart disease known to cause congestive heart failure in early infancy. We report a case using new modalities for early prenatal diagnosis of endocardial fibroelastosis causing fetal heart failure. CASE:A multipara with two children, who died of endocardial fibroel...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/s0029-7844(01)01505-8

    authors: Weiner Z,Shalev E

    更新日期:2001-11-01 00:00:00

  • First-trimester drug use and congenital disorders.

    abstract::The authors determined the prevalence of certain major congenital disorders among live-born infants of 6509 mothers in a prepaid health plan for the 30-month period of January 1, 1980 through June 30, 1982 who used a wide variety of drugs during the first trimester of pregnancy. The results were similar to those obtai...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Aselton P,Jick H,Milunsky A,Hunter JR,Stergachis A

    更新日期:1985-04-01 00:00:00

  • Acute effects of maternal smoking on fetal breathing and movements.

    abstract::The acute effects of cigarette smoking on fetal breathing movements and fetal movements were determined with a real-time ultrasound system in 10 healthy habitually smoking women in late gestation. The study was carried out for 1 hour before and 1 hour after the woman smoked a single cigarette. The maternal blood gluco...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Eriksen PS,Gennser G,Löfgren O,Nilsson K

    更新日期:1983-03-01 00:00:00

  • Induction of an LH surge with estradiol benzoate in a patient with incomplete testicular feminization syndrome.

    abstract::A 31-year-old patient with incomplete testicular feminization syndrome characterized by a 46, XY karyotype in a phenotypic female with absent müllerian structures, marked clitoromegaly, testes and wolffian duct structures, partial labioscrotal fold fusion, and male levels of circulating androgens is described. She was...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Hochman J,Ganguly M,Weiss G

    更新日期:1977-01-01 00:00:00

  • Preeclampsia: is induction of labor more successful?

    abstract:OBJECTIVE:To test the hypothesis that preeclamptic women are more readily inducible than are nonpreeclamptic women, regardless of cervical condition. METHODS:One hundred eighty-three preeclamptic women and 461 nonpreeclamptic women requiring labor induction were studied prospectively. Patients were categorized by Bish...

    journal_title:Obstetrics and gynecology

    pub_type: 临床试验,杂志文章

    doi:10.1016/S0029-7844(97)00043-4

    authors: Xenakis EM,Piper JM,Field N,Conway D,Langer O

    更新日期:1997-04-01 00:00:00