Β Regression Curve - Serum Gonadotropin Human Chorionic Gonadotropin In Patients With Low Risk Trophoblasts That Receive Single Methotrexat Chemotherapy In RSUP. H. Adam Malik Medan
Introduction
Malignant trophoblast disease is a type of malignancy that is sensitive to chemotherapy with methotrexate. However, the effectiveness of this treatment can be hampered by resistance that may occur. Monitoring of serum levels of β-HCG during the chemotherapy process is very important both to determine the success of treatment and to predict the possibility of chemoresistance. Therefore, this study aims to find out how the β-HCG serum regression curve functions in early identification of resistance to the methotrexate.
Background
Malignant trophoblast disease is a type of cancer that affects the placenta and is characterized by the abnormal growth of trophoblast cells. It is a type of gestational trophoblastic disease (GTD) that can occur after a miscarriage, abortion, or ectopic pregnancy. The disease is usually treated with chemotherapy, and methotrexate is one of the most commonly used drugs. However, the effectiveness of methotrexate can be hampered by resistance, which can lead to treatment failure and poor outcomes.
Research Purpose
The main purpose of this study is to determine the serum β-HCG regression curve in patients with low-risk malignant trophoblast disease undergoing a single methotrexate chemotherapy at H. Adam Malik Hospital Medan. This research is expected to provide insight into the effectiveness of therapy and provide useful information for patient management.
Research Methods
This study is a descriptive study with a case series design, which was conducted by analyzing 34 medical records of patients with low-risk malignant trophoblast diseases that receive a single methotrexate chemotherapy from January 2010 to December 2014. Various parameters such as age, parity, anatomy pathology results, Figo scores with Low risk, the presence of metastasis, and pra-cemotherapy β-HCG levels is measured as a prognostic factor. Furthermore, the β-HCG serum level curve for complete remission groups and resistance groups is analyzed descriptively.
Research Result
The results showed that 2.5% of patients succeeded in achieving the normal value of β-HCG after the second cycle of the methotrexate, 50% after the fourth cycle, and 97.5% of patients reached a normal value after the tenth cycle. There are striking variations in β-HCG regression in the 50th percentile group, where an increase in levels in the eighth cycle before finally returning to normal in the ninth cycle. Observation shows that before starting chemotherapy, there are 2 (28.5%) of 7 patients in resistance groups whose levels of β-HCG are higher than the normal limit (97.5 percent) of complete remission groups. Before the second cycle began, 3 (42.8%) of 7 patients also showed levels above the percentage of 9.75, and towards the end of the fourth cycle, all (100%) of 5 patients treated showed above normal limits to the diagnosis of resistance set.
Discussion
From the results obtained, it appears that the serum β-HCG regression curve for complete remission groups reaches a normal value faster than groups that experience methotrexate resistance. This shows that periodic monitoring of β-HCG levels can provide an initial signal regarding the patient's response to treatment. LOS that occurs in the 8th cycle may be an indicator of the development of resistance, which is very important to note.
Knowing the pattern of this regression curve is very crucial in managing therapy, because it can help doctors in making decisions about the need for modification of therapy or additional interventions for patients who show signs of resistance. Thus, this study not only contributes to understanding the effectiveness of the methotrexate, but also underlines the importance of careful monitoring in the treatment of malignant trophoblast disease.
Conclusion
Overall, the analysis of serum β-HCG regression curves can be an important tool in monitoring the effectiveness of metotrexate therapy in patients with low risk trophoblasts. This study shows that complete remission groups show faster recovery than groups that show resistance, thus providing a strong basis for better management in future patients.
Implication
The findings of this study have several implications for the management of malignant trophoblast disease. Firstly, it highlights the importance of monitoring β-HCG levels during chemotherapy to predict the possibility of chemoresistance. Secondly, it suggests that the serum β-HCG regression curve can be used as an indicator of treatment response, and that patients who show signs of resistance may require modification of therapy or additional interventions. Finally, it underscores the need for careful monitoring of patients with malignant trophoblast disease to prevent treatment failure and poor outcomes.
Limitation
This study has several limitations that should be noted. Firstly, the sample size was relatively small, and the study was conducted in a single hospital. Secondly, the study only analyzed β-HCG levels and did not consider other prognostic factors that may influence treatment response. Finally, the study did not investigate the long-term outcomes of patients with malignant trophoblast disease.
Future Research
Future research should aim to investigate the long-term outcomes of patients with malignant trophoblast disease, and to explore the use of other prognostic factors in predicting treatment response. Additionally, studies should be conducted to investigate the effectiveness of different chemotherapy regimens in patients with malignant trophoblast disease.
Recommendation
Based on the findings of this study, it is recommended that patients with malignant trophoblast disease undergo regular monitoring of β-HCG levels during chemotherapy to predict the possibility of chemoresistance. Additionally, healthcare providers should be aware of the importance of careful monitoring of patients with malignant trophoblast disease to prevent treatment failure and poor outcomes.
Q&A: Serum β-HCG Regression Curve in Patients with Low Risk Trophoblasts who Get a Single Methotrexate Chemotherapy at H. Adam Malik Hospital Medan
Q: What is the purpose of this study?
A: The main purpose of this study is to determine the serum β-HCG regression curve in patients with low-risk malignant trophoblast disease undergoing a single methotrexate chemotherapy at H. Adam Malik Hospital Medan.
Q: What is the significance of monitoring β-HCG levels during chemotherapy?
A: Monitoring β-HCG levels during chemotherapy is very important both to determine the success of treatment and to predict the possibility of chemoresistance.
Q: What are the results of this study?
A: The results showed that 2.5% of patients succeeded in achieving the normal value of β-HCG after the second cycle of the methotrexate, 50% after the fourth cycle, and 97.5% of patients reached a normal value after the tenth cycle.
Q: What is the difference between complete remission groups and resistance groups?
A: The serum β-HCG regression curve for complete remission groups reaches a normal value faster than groups that experience methotrexate resistance.
Q: What is the implication of this study?
A: The findings of this study have several implications for the management of malignant trophoblast disease. Firstly, it highlights the importance of monitoring β-HCG levels during chemotherapy to predict the possibility of chemoresistance. Secondly, it suggests that the serum β-HCG regression curve can be used as an indicator of treatment response, and that patients who show signs of resistance may require modification of therapy or additional interventions.
Q: What are the limitations of this study?
A: This study has several limitations that should be noted. Firstly, the sample size was relatively small, and the study was conducted in a single hospital. Secondly, the study only analyzed β-HCG levels and did not consider other prognostic factors that may influence treatment response. Finally, the study did not investigate the long-term outcomes of patients with malignant trophoblast disease.
Q: What are the recommendations of this study?
A: Based on the findings of this study, it is recommended that patients with malignant trophoblast disease undergo regular monitoring of β-HCG levels during chemotherapy to predict the possibility of chemoresistance. Additionally, healthcare providers should be aware of the importance of careful monitoring of patients with malignant trophoblast disease to prevent treatment failure and poor outcomes.
Q: What are the future research directions?
A: Future research should aim to investigate the long-term outcomes of patients with malignant trophoblast disease, and to explore the use of other prognostic factors in predicting treatment response. Additionally, studies should be conducted to investigate the effectiveness of different chemotherapy regimens in patients with malignant trophoblast disease.
Q: What are the clinical implications of this study?
A: The clinical implications of this study are that healthcare providers should be aware of the importance of careful monitoring of patients with malignant trophoblast disease to prevent treatment failure and poor outcomes. Additionally, patients with malignant trophoblast disease should undergo regular monitoring of β-HCG levels during chemotherapy to predict the possibility of chemoresistance.
Q: What are the research implications of this study?
A: The research implications of this study are that it highlights the importance of monitoring β-HCG levels during chemotherapy to predict the possibility of chemoresistance. Additionally, it suggests that the serum β-HCG regression curve can be used as an indicator of treatment response, and that patients who show signs of resistance may require modification of therapy or additional interventions.
Q: What are the future directions for research in this area?
A: Future research should aim to investigate the long-term outcomes of patients with malignant trophoblast disease, and to explore the use of other prognostic factors in predicting treatment response. Additionally, studies should be conducted to investigate the effectiveness of different chemotherapy regimens in patients with malignant trophoblast disease.