Single-dose actinomycin D in the treatment of postmolar trophoblastic disease.

From 1973 to 1982 single-dose (0.04 mg/kg or 1.25 mg/m2), biweekly actinomycin D was used to treat 28 women with postmolar, good-prognosis trophoblastic disease. Among the 17 patients fully evaluable for response to treatment 12 were nonmetastatic (NMTD) and 5 had lung metastases (MTD). Nine NMTD patients and 5 MTD patients achieved titer remission for an overall cure rate of 82.5%. Three patients were lost to follow-up with elevated serum human chorionic gonadotropin titers. The average number of treatment cycles to achieve titer remission in the successfully treated patient was 4.3. Since the efficacy of the pulse actinomycin D therapy for good-prognosis, postmolar trophoblastic disease is similar to that of the traditional 5-day regimens, it is concluded that it is the treatment of choice because of its greater convenience and lower cost.