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KMID : 0375219920070010175
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Journal of Il Sin Christian Hospital
1992 Volume.7 No. 1 p.175 ~ p.182
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Result with the EMA-CO Regimen in High Risk Gestational Tumors
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박치희
김성금/서성숙/강경화/민보은
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Abstract
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EMA-CO has proved to be an effective and relatively well tolerated treatment for G.T.T. but it has not without its side effects. This is a report of 50 patients(pts)treated at Il Sin Christian Hospital, Pusan, between 1985 and 1991.
EMA-CO was the initial therapy for 21 patients, 13 high and 6 medium and 2 low risk according to the 1983 WHO prognostic score. It was the second line of treatment in 29 pts who had developed resistance to single drug therapy and on re-scoring at
the
start of EMA-CO 9 were high risk. 9 medium and ll were still low risk.
Among the 22 high risk pts there were three deaths and two pts with recurrence after remission who responded to treatment and all remaining pts are in remission.
@ES The toxic effects of treatment were:
@EN (1) Hematological: Hb less than 9.5gm/dl, 64%, White cell count less than 2000/cm, 86% and platelets less than 750,000/cm, 10%, Between 1985-88 unless depression was severe the policy was to wait for spontaneous recovery and only 40.0% of the
pts
were transfused but from 1989 a much more active approach was made and 64.3% were transfused.
Although the precentage of pts requiring delay in treatment was the same in both periods, 81.8% and 85.7% respectively the proportion of times in which the delay was only 1~2 times or only 1~2 days was higher in the latter period compared to the
formed.
(2) Hepatopathy: According to WHO toxicity grading the liber enzymes, SGOT and SGPT, were Grade 2 or above in 9 pts(18%) and 15 pts930%) respectively. In 7 pts treatment had to be modified by omission or reduction of Methotrexate and increase of
VP16
until recovery occurred.
(3) Mucositis was moderate or severe in 52% of pts and was usually associated with leucopenia.
Despite these toxic effects EMA-CO was much better tolerated than previously used CHAMOCA for high and MAC for medium risk pts and has the particular advantage of much less disturbance to home life with only 4-5 days admission per months.
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