title: Dose escalation with pharmacokinetics monitoring in methotrexate chemotherapy of osteosarcoma.
abstract: This paper evaluates the influence of pharmacokinetics monitoring of HDMTX in the treatment of localized operable previously untreated high grade osteosarcoma. 44 patients (group 1) received a T10 protocol with dose adapted only to age. 27 other patients (group 2) had a pharmacokinetics monitored dose adaptation of MTX. The pharmacokinetics monitoring leads to higher dosage, higher area under the concentration/time curve and permits higher toxicity to be avoided. The higher dose intensity of MTX gave higher histologic response rate (66% compared to 45%) and higher 5 year disease free survival (92% compare to 76%). HDMTX treatment of osteosarcoma should be dose adapted to indivi-dual pharmacokinetics.
authors.affiliation: Service d'Oncologie Pediatrique, Hôpital Robert Debre, Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Delepine
authors.forename: G
authors.initials: G
authors.lastname: Delepine
authors.forename: H
authors.initials: H
authors.lastname: Cornille
authors.forename: F
authors.initials: F
authors.lastname: Brion
authors.forename: P
authors.initials: P
authors.lastname: Arnaud
authors.forename: J C
authors.initials: JC
authors.lastname: Desbois
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics; D009362:Neoplasm Metastasis; D012516:Osteosarcoma / Q000097:blood / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D010865:Pilot Projects; D011379:Prognosis; D012074:Remission Induction; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D002955:Leucovorin; D008727:Methotrexate