EMA and EMACO Chemotherapy in High Risk Gestational Trophoblast Disease, which Better?

Abstract

Objective: Determine the best effectiveness and efficacy between EMA and EMACO for patients with high-risk GTN. Results: GTN patients who received EMA showed remissions as high as 74.4% - 96.6% of cases. The side effects of anemia in EMA were less toxic than EMACO, but it wasn’t the case in neutropenia. Two studies showed that 57,1% and 87% patients relapse within 2 years, while none in 5 years and 7 years follow-ups. Discussion: With EMACO use, it has been observed to result in increased morbidity and increased health care costs and when patients experience complications while staying overnight in the hospital, they are not monitored by a good specialist team. Patients treated with EMACO had more peripheral neuropathy as result of vincristine than EMA. The use of EMA certainly requires further evaluation. Conclusion: Patients with High-risk GTN who treated first-line with EMA or EMACO have an excellent prognosis. Both regiments are equally effective. There were differences in treatment scheduling, hospitalization requirements, and toxicity between regimens.