Oncology and Fibroids
Chemotherapy is indicated in gestational trophoblastic disease in (AIIMS Nov 2010)
|A||Persistent increase in β-HCG after evacuation|
|C||Histology shows partial mole|
|D||Number of living children|
[Persistent increase in beta HCG after evacuation]
Prophylactic chemotherapy - indications
a. Patients in whom the serum beta -HCG levels persist at high level or plateau out instead of declining and becoming negative 6 weeks after expulsion of the mole
b. In elderly multiparae or any other patient who may not willing to come for regular follow up
c. In women who are being treated for invasive mole.
d. In there is evidence. of-metastasis irrespective of the level of HCG
e. If the level of excretion exceeds 40,000 IU/24 hours at 4-6 weeks.
The most commonly used regime is the EMA-CO regime which consists of etoposide, methotrexate, actinomycin-D, cyclophosphamide and vincristine on separate occasions 8 days apart.