Dose escalation with pharmacokinetics monitoring in methotrexate chemotherapy of osteosarcoma.
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.
Delepine
N
N
Service d'Oncologie Pediatrique, Hôpital Robert Debre, Paris, France.
Delepine
G
G
Cornille
H
H
Brion
F
F
Arnaud
P
P
Desbois
J C
JC
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
D002955:Leucovorin; D008727:Methotrexate