title: On the safety of perioperative adjuvant chemotherapy with cyclophosphamide, methotrexate and 5-fluorouracil in breast cancer.
abstract: Combination cytotoxic chemotherapy (intravenous cyclophosphamide, methotrexate and 5-fluorouracil) was administered within 36 h of mastectomy to 1629 eligible women with operable breast cancer in a randomized controlled clinical trial. Previously reported unpredictable and severe toxic effects were probably due to an interaction between methotrexate and nitrous oxide used in anesthesia. The addition of intravenous 5-formyl-tetrahydrofolate (Leucovorin) and intensification of postoperative monitoring of patients have decreased toxic effects and enhanced the safety of the chemotherapy regimen.
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D003520:Cyclophosphamide / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007430:Intraoperative Care; D002955:Leucovorin / Q000008:administration & dosage; D008408:Mastectomy; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged
chemical_list: D003520:Cyclophosphamide; D002955:Leucovorin; D005472:Fluorouracil; D008727:Methotrexate