Ruymann F B, Mosijczuk A D, Sayers R J
JAMA. 1977 Dec 12;238(24):2631-3.
During autopsy, an 11-year-old girl with acute lymphocytic leukemia was found to have hepatic fibrosis with a 2.5-cm nodule of hepatocarcinoma. For 5 1/2 of the six years of treatment, chemotherapy consisted of daily orally administered methotrexate with monthly doses of vincristine sulfate and prednisone. The cumulative dose of methotrexate was 2.5 g. To our knowledge, this report constitutes the first association of hepatoma with methotrexate-induced hepatic fibrosis. A careful follow-up of patients receiving methotrexate for malignant neoplasms is urged; caution is suggested in the prolonged use of methotrexate when treating benign disease.
尸检时发现，一名患有急性淋巴细胞白血病的11岁女孩出现肝纤维化，并伴有一个2.5厘米的肝癌结节。在六年治疗期的5年半时间里，化疗方案为每日口服甲氨蝶呤，每月注射硫酸长春新碱和泼尼松。甲氨蝶呤的累积剂量为2.5克。据我们所知，本报告首次指出肝癌与甲氨蝶呤所致肝纤维化有关。强烈建议对接受甲氨蝶呤治疗恶性肿瘤的患者进行密切随访；在治疗良性疾病时，长期使用甲氨蝶呤需谨慎。
