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GTTs arise from fetal tissues and can be divided into three histologic categories, hydatidiform mole, chorioadenoma destruens, and choriocarcinoma. Clinically, it is classified as nonmetastatic, metastatic\u2014low risk, or metastatic\u2014high risk. Diagnosis is based on clinical signs and symptoms, ultrasound and X-ray examinations, and the presence of elevated serum levels of the B-subunit of human chorionic gonadotropin (hCG). Primary therapy for hydatidiform mole is evacuation of the uterine contents. Prophylaxis for metastases with actinomycin D sometimes is performed, but generally is not recommended. For persistent disease that is classified as nonmetastatic or low-risk metastatic, a methotrexate-leucovorin rescue protocol is preferred, with actinomycin D used in patients who show resistance to the regimen. Standard therapy for high-risk metastatic disease involves triple agent therapy with methotrexate, actinomycin D, and chlorambucil, but toxicity is significant. Other alternatives include the modified Bagshawe protocol, a VBC (vinblastine, bleomycin, cisplatin) regimen, cisplatin in combination with vincristine and high-dose methotrexate, and VP16\u2013213 (etoposide) in combination with other agents. Other treatment modalities include radiation and surgery. Use of the most appropriate therapies can maximize the survival of a patient with gestational trophoblastic disease.<\/jats:p>","DOI":"10.1177\/106002808401800703","type":"journal-article","created":{"date-parts":[[2016,5,11]],"date-time":"2016-05-11T12:48:30Z","timestamp":1462970910000},"page":"569-576","source":"Crossref","is-referenced-by-count":3,"title":["Treatment of Gestational Trophoblastic Tumors"],"prefix":"10.1177","volume":"18","author":[{"given":"Lea Ann","family":"Hansen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce D.","family":"Clayton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[1984,7,1]]},"reference":[{"key":"bibr1-106002808401800703","unstructured":"Guyton AC. Textbook of medical physiology. Philadelphia: W.B. Saunders Co. 1981: 1022\u20134."},{"key":"bibr2-106002808401800703","unstructured":"Netter FH. The Ciba collection of medical illustrations. Vol. 2. Reproductive system. 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Davis, 1971: 13\u201354, 154\u201368."},{"key":"bibr17-106002808401800703","first-page":"327","volume-title":"Modern concepts of gynecologic oncology","author":"Hanson MB","year":"1982"},{"key":"bibr18-106002808401800703","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(83)90334-4"},{"key":"bibr19-106002808401800703","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(83)92887-8"},{"key":"bibr20-106002808401800703","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(83)91202-4"},{"key":"bibr21-106002808401800703","first-page":"230","volume-title":"Synopsis of gynecologic oncology","author":"DiSaia PJ","year":"1975"},{"key":"bibr22-106002808401800703","first-page":"181","volume":"9","author":"Takeuchi S","year":"1982","journal-title":"Semin Oncol"},{"key":"bibr23-106002808401800703","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1959.tb49201.x"},{"key":"bibr24-106002808401800703","unstructured":"Robbins SL. Pathologic basis of disease. Philadelphia: W.B. 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