comparison of two therapeutic regimens: methotrexate-folinic acid (8 days) and weekly methotrexate in patients with low risk gestational trophoblastic neoplasia

Background: methotrexate is used in the treatment of low-risk gestational trophoblastic neoplasia. the purpose of this study was to compare the therapeutic responses and side effects of two therapeutic methods which were prescribed for patients suffering from low-risk gestational trophoblastic neoplasia. one method was the daily use of methotrexate-folic acid (for 8 days) and the other was the weekly use of methotrexate. methods:this study is a randomized double-blind clinical trial which was undertaken on 122 patients suffering from low-risk gestational trophoblastic neoplasia, who referred to afzalipoor hospital in kerman city, iran. the patients were randomly divided into two groups: one group took methotrexate-folic acid daily for a period of 8 days (muscular taking of one milligram/kilogram of methotrexate in days 1,3,5 and 7; and 0.1 milligram/kilogram of folic acid in days 2,4,6 and 8); the other group took the same medication weekly (muscular taking of 30 to 50 milligrams per each square meter of body mass every week). results: findings showed that 95% of the patients effectively responded to the 8-day regimen and 90% responded to weekly regimen. five percent of the 8-day regimen group and 10% of the weekly regimen group needed a second treatment. this difference was not significant. concerning the related side effects, only one patient in the weekly regimen group experienced nausea and vomiting, and one patient experienced neutropenia; while 4 patients in the 8-day regimen group experienced nausea and vomiting, one patient had mucositis, 2 patients had conjunctivitis, two patients experienced neutropenia, and one patient had thrombocytopenia. conclusions: considering the related costs, the 8-day regimen was significantly more economical and affordable than the weekly regimen.