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Evaluation and management of brain metastatic patients with high-risk gestational trophoblastic tumors
  1. F. Ghaemmaghami*,
  2. N. Behtash*,
  3. N. Memarpour*,
  4. K. Soleimani*,
  5. P. Hanjani and
  6. F. A. Hashemi
  1. * Department of Gynecology and Oncology, Tehran University of Medical Sciences, Tehran, Iran
  2. Rosenfeld Cancer Center, Abington Memorial Hospital, Abington, PA, USA
  3. Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
  1. Address correspondence and reprint requests to: Fatemeh Ghaemmaghami, MD, Department of Gynecology and Oncology, Vali-e-Asr Hospital, Imam Khomeini Hospital Complex, Keshavarz Blvd, Tehran 14194, Iran. Email: ftghaemmagh{at}


A retrospective study to evaluate the characteristics of brain metastatic patients with gestational trophoblastic tumors (GTT) and to analyze the results of treatment has been performed. During 1996–2001, 40 patients with metastatic GTT were diagnosed at Vali-e-Asr Hospital, Tehran, Iran. Of them, nine with brain metastases, which were documented with the help of computed tomography scan, were evaluated retrospectively. Eight patients received EMA-EP regimen (etoposide, methotrexate, actinomycin, etoposide, and cisplatinum) and one received EMA-CO (etoposide, methotrexate, actinomycin, cyclophosphamide, and vincristin). All cases received whole brain irradiation therapy concurrently. The median age of the patients at diagnosis was 30 years (range: 17–53). Six of them were of early group (five with symptoms of central nervous system and one was detected during workup) and three were of late group (relapsed group). Five (56%) patients responded to treatment and four (44%) were deceased (three of them belonged to late group). It seems that multi-agent chemotherapy (EMA-EP) concurrently with whole brain irradiation results in acceptable survival rates in GTT patients with brain metastases.

  • brain metastatic GTT
  • choriocarcinoma
  • EMA-EP regimen
  • multi-agent chemotherapy

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