以何種Methotrexate方法治療低風險滋養層疾病最佳？

What is the Best Regimen of Methotrexate for Low-Risk Gestational Trophoblastic Disease?

Methotrexate（MTX）為治療妊娠性滋養層疾病最常使用藥物，特別是在沒有轉移病灶和低危險性患者，單獨使用效果很好，包括：（1）每週注射法；（2）連續5天肌肉注射或靜脈注射法；（3）methotrexate與folinic acide隔天注射法，共8天；（4）高劑量methotrexate與folinic acide連續注射法。雖然對低危險性滋養層疾病最理想的方式仍未確定，但回顧文獻結果，以每2週連續5天methotrexate之方式效果最好，且副作用可被接受。

Patients with nonmetastatic and low-risk metastatic gestational trophoblastic disease should be treated with single-agent methotrexate chemotherapy. Several different chemotherapy protocols have been used, including: (1) weekly intramuscular injection; (2) 5-days intramuscular or intravenous push every other week; (3) methotrexate intramuscular every other day alternating with folinic acid over 8 days with at least a 1-week interval; (4) High dose methotrexate infusion with folinic acid beginning 24 hours after start of methotrexate, repeat every 18 days. The best protocol for treating low-risk trophoblastic disease is uncertain, however, 5-day continuing injection every 2 weeks seems to appear a high effective and well-tolerated treatment in literature review.