ĐIỀU TRỊ U NGUYÊN BÀO NUÔI DI CĂN NÃO BẰNG HÓA TRỊ ĐA HÓA CHẤT KẾT HỢP METHOTREXATE TIÊM TỦY SỐNG TẠI BỆNH VIỆN PHỤ SẢN TRUNG ƯƠNG: BÁO CÁO LOẠT CA BỆNH

Abstract

Objective: This study aimed to describe the clinical characteristics, paraclinical findings, and treatment outcomes of patients with brain metastatic gestational trophoblastic neoplasia (GTN) managed with multi-agent chemotherapy combined with intrathecal methotrexate at the Gynecologic Oncology Department, National Hospital of Obstetrics and Gynecology.

Methods: A retrospective case series study was conducted.

Results: We report three cases of brain metastatic GTN presenting with neurological manifestations such as headache, vomiting, blurred vision, impaired consciousness, and motor dysfunction, in addition to abnormal vaginal bleeding following pregnancy. Imaging studies detected brain lesions accompanied by metastases to other organs, including the lungs, liver, and kidneys. All patients received multidisciplinary management, with multi-agent chemotherapy combined with intrathecal methotrexate as the main treatment modality. During treatment, serum β-hCG levels decreased markedly and clinical symptoms improved significantly. The patients remained stable during regular follow-up.

Conclusion: Brain metastatic GTN is a severe form of the disease; however, it is potentially curable if treated promptly and with an appropriate therapeutic strategy. Based on our experience in managing these cases, multi-agent chemotherapy combined with intrathecal methotrexate may provide effective and safe disease control.