High-dose chemotherapy with autologous peripheral blood stem cell transplantation for choriocarcinoma: A case report and literature review

Choriocarcinoma is a malignant gestational trophoblastic neoplasia (GTN) and one of the curable types of gynecological cancer. However, 10% of choriocarcinoma patients have a poor prognosis, particularly when they have metastasis, apart from pulmonary metastasis, or do not go into remission by the s...

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Bibliographic Details
Published in:Molecular and clinical oncology 2016-11, Vol.5 (5), p.660-664
Main Authors: Yamamoto, Eiko, Niimi, Kaoru, Fujikake, Kayo, Nishida, Tetsuya, Murata, Makoto, Mitsuma, Ayako, Ando, Yuichi, Kikkawa, Fumitaka
Format: Article
Language:English
Subjects:
Blood
Brain cancer
Cancer
Care and treatment
Case reports
Chemotherapy
Choriocarcinoma
Diagnosis
Drug dosages
gestational trophoblastic neoplasia
Gynecological cancer
high-dose chemotherapy
ifosfamide
Lungs
Metastasis
Methods
multi-drug resistance
Neutropenia
NMR
Nuclear magnetic resonance
Oncology
Patient outcomes
peripheral blood stem cell transplantation
Stem cell transplantation
Stem cells
Tomography
Transplantation
Tumors
Ulcers
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Summary:Choriocarcinoma is a malignant gestational trophoblastic neoplasia (GTN) and one of the curable types of gynecological cancer. However, 10% of choriocarcinoma patients have a poor prognosis, particularly when they have metastasis, apart from pulmonary metastasis, or do not go into remission by the second chemotherapeutic regimen. We herein present the case of a 36-year-old patient who had choriocarcinoma with metastases to the lungs, liver and kidneys. The 5th and 6th regimens with cisplatin for choriocarcinoma failed and the patient developed brain metastases. She was then treated with four cycles of high-dose ifosfamide, carboplatin and etoposide (ICE) with blood progenitor cell support after confirming the effectiveness of ICE at normal doses. The serum human chorionic gonadotropin (hCG) level was 140,009 mIU/ml at the start of high-dose ICE and the patient tolerated this regimen well. However, the beneficial effect was decreasing with each successive course of treatment, with the lowest level of hCG at 103 mIU/ml after the fourth course. The patient did not achieve complete remission and succumbed to the disease 4 months after the last chemotherapy. The findings of the present case and a review of the related literature suggest that high-dose ICE with stem cell rescue may be considered as a viable treatment option for a multi-drug resistant choriocarcinoma or GTN.
ISSN:2049-9450
2049-9469
DOI:10.3892/mco.2016.1011