@article {Yarandi971, author = {Fariba Yarandi and Azamsadat Mousavi and Fereshteh Abbaslu and Soheila Aminimoghaddam and Sepideh Nekuie and Khadijeh Adabi and Parviz Hanjani}, title = {Five-Day Intravascular Methotrexate Versus Biweekly Actinomycin-D in the Treatment of Low-Risk Gestational Trophoblastic Neoplasia: A Clinical Randomized Trial}, volume = {26}, number = {5}, pages = {971--976}, year = {2016}, doi = {10.1097/IGC.0000000000000687}, publisher = {BMJ Specialist Journals}, abstract = {Objectives Methotrexate (MTX) and Actinomycin-D (Act-D) are effective drugs used in the treatment of low-risk gestational trophoblastic neoplasia (LRGTNs). The aim of the present study was to compare intravenous (IV) MTX and IV Act-D in the treatment of LRGTNs.Materials and Methods Sixty-two patients with LRGTN were enrolled in a prospective randomized clinical trial between 2010 and 2013 in Moheb e Yas Hospital, Tehran University of Medical Sciences. Primary treatment regimens were IV MTX, 0.4 mg/kg daily for 5 days every 14 days (25 mg maximum daily dose), and IV Act-D, 1.25 mg/m2 (2 mg maximum dose) every 14 days.Results Thirty-two and 30 patients were enrolled to MTX and Act-D groups, respectively. Complete remission after receiving first-line chemotherapy was achieved in 79\% of all cases, 80\% in the Act-D group and 78.1\% in the MTX group.Twenty percent of the Act-D patients and 21.9\% of the MTX patients showed resistance to the first-line chemotherapy, of which 16.7\% and 15.6\% responded completely to the second-line monotherapy, respectively. Multiple drug therapy was needed in 3.3\% of the Act-D group and 6.3\% of the MTX group.We did not find any correlation between treatment response and beta{\textendash}human chorionic gonadotropin level, uterine mass size, lung metastasis, antecedent pregnancy, and duration from diagnosis to treatment. Adverse effects were not statistically different between the 2 groups.Conclusions Single-agent chemotherapy in the treatment of LRGTNs resulted in an overall complete remission rate of 79\%, 80\% in the Act-D group and 78.1\% in MTX group, with no statistically significant difference. Whereas this study represents an important step in comparing single-agent treatments, comparison of other regimens will be required to determine the optimal single-agent therapy.}, issn = {1048-891X}, URL = {https://ijgc.bmj.com/content/26/5/971}, eprint = {https://ijgc.bmj.com/content/26/5/971.full.pdf}, journal = {International Journal of Gynecologic Cancer} }