Dactinomycin or Methotrexate in Treating Patients With Low-Risk Gestational Trophoblastic Neoplasia

Inclusion Criteria: * Patients who meet International Federation of Gynecology and Obstetrics (FIGO) stage I, II, or III criteria for low-risk gestational trophoblastic neoplasia (GTN): post molar GTN or choriocarcinoma (as defined below); patients may have had a second curettage but must still meet GTN criteria below: * Post molar GTN * For the purposes of this study, patients must have undergone evacuation of a complete or partial hydatidiform mole and then meet the criteria for GTN defined as: * A \< 10% decrease in the hCG level using as a reference the first value in the series of 4 values taken over a period of 3 weeks (\> 50 mIU/ml minimum) OR * A \> 20% sustained rise in the hCG taking as a reference the first value in the series of 3 values taken over a period of 2 weeks (\> 50 mIU/ml minimum) OR * A persistently elevated hCG level a period of 6 months or more following the initial curettage (\> 50 mIU/ml minimum) * Choriocarcinoma * Histologically proven non-metastatic choriocarcinoma OR * Histologically proven metastatic choriocarcinoma if the metastatic site(s) is restricted to one (or more) of the following: vagina, parametrium, or lung * World Health Organization (WHO) risk score 0-6 * Patients must be willing to practice effective contraception for the duration of the study * White blood cell count (WBC) \>= 3,000 cells/mcL * Granulocytes \>= 1,500/mcL * Platelets \>= 100,000/mcL * Creatinine =\< 2.0 mg/dcL * Bilirubin =\<…