Five years' experience with the chemotherapy of metastatic choriocarcinoma and related trophoblastic tumors in women

      This paper is only available as a PDF. To read, Please Download here.


      In 63 women with metastatic trophoblastic disease, intensive chemotherapy with the folic acid antagonist amethopterin supplemented in some by vincaleukoblastine, an oncolytic plant alkaloid, has led to complete remission in 30 patients who have been free of hormonal, radiological, or physical evidence of residual disease for from 6 months to 5 years. Seven patients now in incomplete remission continue on treatment. In addition, of the 26 patients who have died, 22 had obtained substantial but incomplete remission. Such remissions were characterized by marked suppression of tumor, in many instances leaving a persistently elevated hormone titer as the only evidence of persistent disease. Such incomplete remissions have lasted from 1 month to more than 43 months.
      The hazards of toxicity attendant upon this intensive form of chemotherapy may be largely obviated by proper case selection, by less intensive therapy in patients with liver or renal impairment, and by adequate supportive medical and nursing care, thus rendering the risk involved clinically acceptable.
      The highly variable clinical course of choriocarcinoma and related trophoblastic disease, with its indeterminate frequency of spontaneous regression, renders an exact appraisal of therapeutic accomplishment very difficult. However, the present data clearly establish the substantial therapeutic value of intensive chemotherapy in women with metastatic tumors of trophoblastic origin.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Obstetrics & Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Li M.C.
        • Hertz R.
        • Spencer D.B.
        Proc. Soc. Exper. Biol. & Med. 93. 1956: 361
        • Li M.C.
        • Hertz R.
        • Bergenstal D.M.
        New England J. Med. 1958; 259: 66
        • Hertz R.
        • Bergenstal D.M.
        • Lipsett M.B.
        • Price E.B.
        • Hilbish T.F.
        J. A. M. A. 1958; 168: 845
        • Johnson I.S.
        • Wright H.F.
        • Svoboda G.H.
        • Vlantis J.
        Cancer Res. 1960; 20: 1016
        • Hertz R.
        Proc. Soc. Exper. Biol. & Med. 102. 1959: 77
        • Hertz R.
        • Lipsett M.B.
        • Moy R.H.
        Cancer Res. 1960; 20: 1050
        • Novak E.
        • Seah C.S.
        Am. J. Obst. & Gynec. 1954; 67: 933
        • Klinefelter H.F.
        • Albright F.
        • Griswold G.C.
        J. Clin. Endocrinol. 1943; 3: 529
        • Delfs E.
        Obst. & Gynec. 1957; 9: 1
        • Park W.W.
        Modern Trends in Pathology. Butterworth & Co., Ltd, London1960 (chap. 10)
        • Park W.W.
        Arch. Path. 1950; 49: 73
        • Park W.W.
        Arch. Path. 1950; 49: 205
        • Brewer J.I.
        • Rinehart J.J.
        • Dunbar R.W.
        Am. J. Obst. & Gynec. 1961; 81: 574
        • Greene R.R.
        Ann. New York Acad. Sc. 1959; 80: 143
        • Douglas G.W.
        Trophoblast and Its Tumors. vol. 80. 1959: 195
        • King G.
        Proc. Roy. Soc. Med. 49. 1956: 381