4. Cohort studies of EMA‐CO for primary treatment of high‐risk GTN.
| Study ID | Study period | Country | Participants with high‐risk GTN undergoing primary treatment |
CT regimen | Primary remission rate (CR) |
Median follow‐up (months) |
OS |
| Bolis 1988 | 1980 to 1985 | Italy | 22 | EMA/CO | 94% | 32 | 88% |
| Soper 1994 | 1966 to 1992 | North America | 6 | EMA/CO | 67% | ‐ | ‐ |
| Schink 1992 | 1986 to 1991 | North America | 12 | EMA/CO | 83% | 26 | 100% |
| Newlands 1998; Bower 1997 | 1979 to 1995 | UK | 272 ¹ | EMA/CO | 78% | 54 | 87% |
| Kim 1998 | 1971 to 1995 | Korea | 227 ² | EMA/CO (96); MA (49); MAC (40); CHAMOCA (42) |
EMA/CO: 91%; MA: 63%; MAC: 68%; CHAMOCA: 76% | All follow‐up exceeded 24 months | ‐ |
| Escobar 2003 | 1986 to 2001 | North America | 25 | EMA/CO | 76% | 36 | 92% |
| Turan 2006 | 1994 to 2004 | Turkey | 23 | EMA/CO | ‐ | 53 | 91% |
| Lu 2008 | 1996 to 2005 | China | 45 | EMA/CO | 78% | 56 ⁴ | 93% |
| Lurain 2010 | 1989 to 2009 | North America | 26 | EMA/CO | 62%⁷ | ‐ | 92% |
| Chauhan 2010 | 1995 to 2008 | India | 67³ | EMA/CO | 75% (43/57) | range, 12 to 72 | 93% |
| Cyriac 2011a | 1997 to 2006 | India | 29 | EMA/CO | 76% | 47 | 71% |
| Bianconi 2012 | 1990 to 2011 | Argentina | 23 | EMA/CO (for scores 7 to 13); EMA/EP for scores > 13 |
83% | ‐ | 93% |
| Cagayan 2012 | 2006 to 2010 | Phillipines | 67 | EMA/CO ⁵ | 71% | ‐ | 86% |
| Fülöp 2012 | 1977‐ to 2010 | Hungary | 174 | EMA/CO (26); MAC (118); BEP (17) ⁶ |
EMA/CO: 81%; MAC: 93% BEP: 94% |
‐ | 97% |
| CT: chemotherapy; CR: complete response; OS: overall survival; EMA/CO: etoposide, methotrexate, actinomycin D/cyclophosphamide, vincristine; EMA/EP: etoposide, methotrexate, actinomycin D/etoposide, cisplatin; MAC: methotrexate, actinomycin D, cyclophosphamide or chlorambucil; BEP: bleomycin, etoposide, cisplatin. | |||||||
¹ This study included 121 women undergoing secondary/salvage treatment.
² MA and MAC were used mainly between 1971 and 1982; CHAMOCA was used between 1982 and 1985; EMA/CO was used from 1985 to 1995. Mean age and prognostic scores were similar in these groups.
³ Only 57 were treated with EMA/CO, the other 10 were treated with EMA.
⁴ Mean not median.
⁵ 56 women completed treatment.
⁶ Prognostic scores differed between these treatment groups as follows: MAC = 11.5, EMA/CO = 13.2 and BEP = 15.5.
⁷ Two patients relapsed from remission at 4 and 5 months therefore the overall durable CR was 54%.