en Gynecology & Obstetrics Gynecology & Obstetrics Original Research Original Research <p> <strong> Background </strong>: Gestational trophoblastic neoplasia (GTN) refers to malignant lesions that arise from abnormal proliferation of placental trophoblast. Even in its metastatic forms GTN is curable with a cure rate of 90-100 %. Currently, methotrexate with or without folic acid, andactinomycin D is recommended for low risk GTN. The aim of this study is to compare the efficacy of methotrexate and actinomycin D as the first-line single chemotherapeutic agents for women with low-risk gestational trophoblastic neoplasia (LR-GTN). </p><p> <strong> Methods: </strong>A total of 30 women with LR-GTN were randomized to receive a weekly pulsed dose of 40 mg/m (2) of methotrexate intramuscularly (n=15) or a pulsed intravenous bolus of 1.25 mg/m (2) of actinomycin D every 2 weeks (n=15). An additional cycle was administered as consolidation treatment following normalization of the serum level of beta-human chorionic gonadotropin (˂10 IU/L). </p><p> <strong> Results: </strong>Complete remission was achieved in 53.3% of patients in the methotrexate group and 86.7% in the actinomycin D group (p˂0.04). The mean number of treatment cycles needed to achieve response was lower in the actinomycin D group (4.3 vs. 6.5). The mean duration from beginning of treatment till achieving complete remission was 9.6 weeks for the Act group and 13 weeks for the MTX group.<strong></strong> </p><p> <strong> Conclusion: </strong>Actinomycin D may be a better option than methotrexate as a first-line chemotherapy agent for patients with LR-GTN but larger multicenter randomized controlled trials should be conducted to establish the most appropriate regimen for these patients. </p> Actinomycin D, Methotrexate, Gestational Trophoblastic Disease (GTD). 483 488 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-1-707&slc_lang=en&sid=1 Nahid Shahbazian Shahbazian449@yahoo.com 200319475328460012677 200319475328460012677 No Ahvaz Jundishapour University of Medical Sciences, Ahvaz, Iran Taghi Razi Dr.taghirazi@gmail.com 200319475328460012678 200319475328460012678 No Ahvaz Jundishapour University of Medical Sciences, Ahvaz, Iran. Shima Razi Landscapes78@yahoo.com 200319475328460012679 200319475328460012679 No Ahvaz Jundishapour University of Medical Sciences, Ahvaz, Iran. Leila Yazdanpanah Leila.yazdanpanah@gmail.com 200319475328460012680 200319475328460012680 Yes Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.