A 38-year-old woman undergoes chemotherapy for low-risk gestational trophoblastic neoplasia (FIGO score 3) with weekly intramuscular methotrexate. After three cycles, her β-hCG becomes undetectable. How many additional cycles of chemotherapy are recommended after the first normal β-hCG?

• A No further cycles; monitor with β-hCG
• B One consolidation cycle
• C Six consolidation cycles
• D Two to three consolidation cycles ✓

Explanation

Standard practice for low-risk GTN is to administer 2 to 3 consolidation chemotherapy cycles after the first normal β-hCG value to reduce relapse risk. Stopping immediately upon achieving remission leads to higher relapse rates. The exact number varies by protocol, but 2-3 cycles is the widely accepted recommendation from Charing Cross and other major centres.

Reference: Bagshawe's Textbook of Gestational Trophoblastic Disease, 3rd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.