Treatment with 4-amino-N10 methyl pteroylglutamic acid (Methotrexate) was carried out in 27 patients with tumors classified as trophoblastic. In each case the patient's urinary excretion of chorionic gonadotropic hormone served to indicate the nature and status of the tumor. In 19 cases the diagnosis was choriocarcinoma; in 3 it was chorioadenoma. The drug was given in five-day courses at a daily dose of 10 to 30 mg., usually administered intramuscularly but sometimes by continuous intravenous drip. In five patients a complete remission was observed; all hormonal, radiologic, and physical evidence of the tumor remained in abeyance for periods ranging from 8 to 29 months. Partial remissions were obtained in 7 and transient remissions in 10 cases. Six patients have died after the initial transient response. In five cases no remission was seen. The treatment involved a substantial hazard, for sideeffects were often severe and not always reversible. In view of the striking nature of the results in some cases, the morbidity and mortality must be accepted as hazards of the treatment in its present form.
Hertz R, Bergenstal DM, Lipsett MB, Price EB, Hilbish TF. CHEMOTHERAPY OF CHORIO CARCINOMA AND RELATED TROPHOBLASTIC TUMORS IN WOMEN. JAMA. 1958;168(7):845–854. doi:10.1001/jama.1958.03000070001001
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