A case of elderly choriocarcinoma treated with low-dose etoposide cisplatin therapy

Abstract

Synopsis: A low-dose regimen of Etoposide and Cisplatin (EP) has been established as an induction chemotherapeutic strategy to reduce the mortality risk of chemotherapy-related mortality in patients with choriocarcinoma or germ cell tumors, especially those in poor general status. An 80-year-old patient consulted her family physician with a complaint of abnormal uterine bleeding. She was referred to the gynecology department at the secondary hospital. With a preoperative diagnosis of uterine sarcoma, she underwent an abdominal hysterectomy and bilateral adnexectomy. Pathological examination revealed ovarian choriocarcinoma, and she was referred to our institution. The residual tumors were rapidly growing. Diagnostic imaging identified a 16 cm tumor with pulmonary and hepatic metastases. Serum hCG levels were high at 502,241 mIU/mL. After twenty-two cycles of low-dose EP, the pelvic mass was surgically removed. The patient has been free from recurrence for two years. Although comprehensive chemotherapy for choriocarcinoma often results in considerable side effects, it remains efficacious for many healthy patients under age 50. The patient was 80 years old and considered to be at high risk for conventional regimens. The continuation of low-dose EP was successful. Therefore, continuing low-dose EP therapy is an alternative for older patients, striking a balance between effectiveness and tolerability.