A 26-year-old woman develops GTN after a term delivery (non-molar). She is classified as low-risk by the FIGO/WHO prognostic scoring system. The FIRST-LINE chemotherapy is:
- A EMA-CO (etoposide, methotrexate, actinomycin-D, cyclophosphamide, vincristine)
- B Single-agent methotrexate or actinomycin-D ✓
- C Cisplatin-based combination chemotherapy
- D BEP (bleomycin, etoposide, cisplatin)
Correct answer: B. Single-agent methotrexate or actinomycin-D
Explanation
Low-risk GTN (FIGO/WHO score 0–6) is treated with single-agent chemotherapy: either methotrexate (with folinic acid rescue) or actinomycin-D. Remission rates exceed 85–90% with single-agent therapy. EMA-CO is reserved for high-risk GTN (WHO score ≥7) or cases resistant to single-agent treatment. BEP is used for germ cell tumors, not GTN.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.