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Single-Agent Chemotherapy

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Gestational Trophoblastic Disease

Part of the book series: Clinical Perspectives in Obstetrics and Gynecology ((CPOG))

Abstract

It has been 30 years since Hertz and associates at the National Cancer Institute ushered in a new era in chemotherapy with their report of complete regression of metastatic choriocarcinoma with methotrexate (MTX).1 Since that time gestational trophoblastic disease (GTD) has proved to be unique in that it can be predictably cured even in the presence of widespread metastases.2 During the three decades since the introduction of chemotherapy, there have been three important advances that have enabled clinicians to identify earlier those patients who require intervention and to predict more accurately their response to treatment. First, there has emerged a better understanding of the natural history of trophoblastic disease including its sequelae following both molar and nonmolar pregnancies. Second, there has been improvement in the methods of measuring human chorionic gonadotropin (hCG) in small aliquots of serum, essential for diagnosis, monitoring the response to therapy, and long-term follow-up. Third, the development of regional centers has enabled a small number of specialized clinicians to treat large numbers of patients with an uncommon condition. This has facilitated the development of treatment protocols that best suit the needs of individual patients, thus avoiding overtreatment of some and undertreatment of others. The regional centers have also facilitated research in the etiology and treatment of this disease, because of the availability of larger numbers of patients.

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Authors
  1. Donald P. Goldstein
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  2. Ross S. Berkowitz
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Editor information

Editors and Affiliations

  1. Magee Womens Hospital, University of Pittsburgh School of Medicine, 15213, Pittsburgh, PA, USA

    Aron E. Szulman M.B., Ch.B., FRCPath (Professor of Pathology) (Professor of Pathology)

  2. Magee Womens Hospital, University of Pittsburgh, 15213, Pittsburgh, PA, USA

    Herbert J. Buchsbaum M.D. (Professor of Obstetrics and Gynecology) (Professor of Obstetrics and Gynecology)

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© 1987 Springer-Verlag New York Inc.

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Goldstein, D.P., Berkowitz, R.S. (1987). Single-Agent Chemotherapy. In: Szulman, A.E., Buchsbaum, H.J. (eds) Gestational Trophoblastic Disease. Clinical Perspectives in Obstetrics and Gynecology. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-4698-5_13

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  • DOI: https://doi.org/10.1007/978-1-4612-4698-5_13

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-9119-0

  • Online ISBN: 978-1-4612-4698-5

  • eBook Packages: Springer Book Archive

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