Serum concentration monitoring of methotrexate in patients with osteosarcoma
Qiao Xiaoyun
Qiao Yuan
Wang Rong
Abstract：Objective To analyze serum concentration monitoring of high-dose methotrexate (HD-MTX)for rational use of calcium folinate (CF) in treating osteosarcoma.Methods Totally 67 osteosa-rcoma patients with or without operation from January 2012 to October 2014 were divided into MTX 8 g/m2 group (34 cases) and MTX 10 g/m2 group (33 cases).The serum concentrations of MTX in 67 cases were determined by enzyme-enhancement immunoassay technique 0, 24, 48 and 72 h after treatment (Cx, x =0, 24, 48, 72).The relation among Cx, age, gender and dosages was analyzed;the toxicity of MTX was observed;the times and dosages of CF for rescue treatment in patients with C24 ≥5.0 μmol/L and/or C48 ≥0.5 μmol/L and/or C72 ≥0.2 μmol/L were recorded.Results C0 and C24 in MTX 8 g/m2 group were significantly lower than those in MTX 10 g/m2 group [(548.01 ±127.03) μmol/L vs (839.48 ±113.09) μmol/L, (4.61 ±1.46) μmol/L vs (5.79 ±3.01) μmol/L] (P ＜ 0.05);C48 and C72 showed no significant differences between the two groups (P ＞ 0.05).Cx at different time points was not significantly different among patients of different age and gender in both groups(P ＞ 0.05).Totally 11 cases (32.4％) in MTX 8 g/m2 group, 16 cases (48.5％) in MTX 10 g/m2 group had C24 and/or C4s and/or C72 above safety value.In MTX 10 g/m2 group, the dosages and times of CF for rescue treatment were significantly increased compared with those in MTX 8 g/m2 group [(132 ± 66) mg vs (104 ± 31) mg, (7.2 ± 1.9) times vs (6.5 ± 1.5) times, P ＜ 0.05].There was no significant difference regarding toxicity between two groups.Conclusion On the basis of general dosage of 6 ～ 12 g/m2 , the peak serum concentration of HD-MTX is significantly increased, the removal of MTX is delayed with increase of dosage;adjusting the dosage and usage of CF according to the results of serum concentrations monitoring of MTX, the toxicity can be prevented and reduced.
Keywords：OsteosarcomaHigh-dose methotrexateSerum concentration monitoringEnzyme-enhancement immunoassay technique
Publication Date：2015-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 1633-1637 )