| Table 3: Treatment protocols for stage I gestational trophoblastic neoplasia (New England Trophoblastic Disease Center). |
| | Initial | Sequential MTX/ACT-D | | Hysterectomy (with adjunctive single-agent chemotherapy) |
| | Resistant to both single-agents | MAC | | EMACO, if MAC fails | | Hysterectomy (with adjunctive multiagent chemotherapy) | | Local uterine resection (for localized lesion, to preserve, fertility) |
| | Followup | 12 consecutive months of normal hCG levels | | Contraception mandatory |
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ACT-D: actinomycin D; EMACO: etoposide, methotrexate, actinomycin D, cytoxan, oncovin; MAC: methotrexate, actinomycin D, cytoxan; MTX: methotrexate.
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