Treatment of Gestational Trophoblastic Neoplasia Following Complete Molar Pregnancy with a FIGO 2000 Score of 6 or Less (Low Risk)

This protocol applies to patients who develop gestational trophoblastic neoplasia (GTN) after a complete hydatidiform mole and whose FIGO 2000 score places them in the low-risk category.

Clinical Scenario

Before starting treatment, women are assessed using the FIGO 2000 scoring system. A total score of 6 or less classifies the patient as low risk and determines the treatment pathway.

Treatment Approach

Low-risk GTN following complete molar pregnancy is treated with a specific single-agent chemotherapy regimen — the complete schedule, administration details, and continuation criteria are contained in the full protocol.

Treatment Goal

The primary endpoint is normalisation of the hCG level. Treatment continues beyond that point for a defined further period specified in the full regimen.

References
DOI: 10.1111/1471-0528.16266

Women are assessed before chemotherapy using the FIGO 2000 scoring system (Table 1).

Women with scores of 6 or less are at low risk and are treated with single-agent intramuscular methotrexate, alternating daily with folinic acid for 1 week followed by 6 rest days.

Women with GTN may be treated with single-agent or multi-agent chemotherapy.

Treatment is continued, in all cases, until the hCG level has returned to normal and then for a further 6 consecutive weeks.

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