COMPARATIVE ANALYSIS OF THE TREATMENT OF GESTATIONAL TROPHOBLASTIC DISEASE WITH ETOPOSIDE AND METHOTREXATE

COMPARATIVE ANALYSIS OF THE TREATMENT OF GESTATIONAL TROPHOBLASTIC DISEASE WITH ETOPOSIDE AND METHOTREXATE

• Autor
• Eduardo Fernandes dos Santos
• Co-autores
• Rigoberto Rodrigues de Lima Filho , Julia Barbosa Sales de Lima , Maria Jamylly Soares de Macedo , Nathália Maria Amaro Rocha , Ana Carolina Donin , Rafaelly Siqueira , André Luiz Cunha Cavalcante , Janaina da Silva Feitoza Palácio , Maria Eduarda Ribeiro Machado , Marcus Antonio Lessa Silva Junior , Sofia Brito Lourenço , Beatriz Santana Sales , Márcia Bandeira Bringe , Elisangela Araújo da Silva , Hildo Santiago Reis de Aguiar , Sophia Rodrigues Augusto Gonçalves , Pedro Henrique Pereira Santos , Gabriel Abrantes Farias , Thainara Ferreira Campos , Pedro Henrique da Costa Lucena , Ana Carolina Naves Panucci , Jesus Ramon Bravo Vasconcelos Filho , Débora Nogueira Milagres , Marcos Reis Garcia , Katarine Tavares Rocha , Layara Eulalia Machado Lunkes
• Resumo

• RESUMO: Considering the complexity and variability in the treatment of gestational trophoblastic disease (GTD), particularly in cases resistant to standard therapies such as methotrexate, there is an urgent need to explore alternative chemotherapy regimens that can effectively manage these cases. This study aims to systematically review and compare the efficacy of different chemotherapy regimens, including those based on etoposide and methotrexate, in treating both low-risk and high-risk gestational trophoblastic neoplasia (GTN). A narrative literature review was conducted, analyzing a wide range of studies and case reports that explore the outcomes of various chemotherapy protocols, such as EMA-CO, EP/EMA, and TIP, among others. The review included data from studies published between 2015 and 2021, sourced from databases such as PubMed, Scopus, and Web of Science. The results indicate that while methotrexate remains a commonly used first-line treatment, its efficacy in high-risk and resistant GTN cases is often limited, necessitating the use of alternative regimens like EMA-CO or TIP, which have shown higher complete response rates in resistant cases. Additionally, the review highlights the significant challenges associated with managing GTN with brain metastasis or other severe complications, where more aggressive treatments, including surgical interventions, may be required. It is concluded that although alternative regimens like EMA-CO and TIP offer promising results, the choice of therapy should be carefully tailored to the individual patient's risk profile and response to treatment. Further research is needed to refine these treatment strategies and develop more standardized guidelines for managing resistant and recurrent GTN, with an emphasis on balancing efficacy with toxicity.

   

• Palavras-chave
• Gestational trophoblastic disease, Chemotherapy regimens, Methotrexate resistance, EMA-CO, Etoposide, TIP therapy.
• Área Temática
• Artigo Não Indexado, Políticas Sociais, Administração e Recursos na Saúde;

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