Savani Malvi, Skubitz Keith M
Department of Medicine, Division of Hematology, Oncology and Transplantation, University of Minnesota Medical Center, Minneapolis, MN.
J Pediatr Hematol Oncol. 2019 Mar;41(2):e94-e96. doi: 10.1097/MPH.0000000000001264.
Current treatment of high-grade osteosarcoma consists of preoperative chemotherapy, typically using some combination of doxorubicin, cisplatin, ifosfamide, and/or high-dose methotrexate followed by surgical resection. In this report, we present a case of a 21-year-old woman with high-grade osteosarcoma of the chest wall who received 5 times the planned dose of doxorubin and 4 times the planned dose of ifosfamide. She survived this chemotherapy overdose after administration of dimethyl sulfoxide and phenobarbital. Despite the administration of 5 times the proposed dose of doxorubicin, the patient survived without cardiotoxicity, and later delivered a normal baby. Although there are many studies evaluating treatment for chemotherapy regimen-related toxicity, sparse data exist with respect to chemotherapy overdose and the appropriate course of action. This case further confirms the lower cardiotoxicity of continuous intravenous infusion of doxorubicin and provides support for the use of dimethyl sulfoxide in the prevention of toxicity in chemotherapy overdose.
目前，高级别骨肉瘤的治疗方法包括术前化疗，通常联合使用多柔比星、顺铂、异环磷酰胺和/或大剂量甲氨蝶呤，随后进行手术切除。在本报告中，我们介绍了一名21岁患有胸壁高级别骨肉瘤的女性病例，她接受的多柔比星剂量为计划剂量的5倍，异环磷酰胺剂量为计划剂量的4倍。在给予二甲亚砜和苯巴比妥后，她从这次化疗过量中存活下来。尽管给予了5倍于建议剂量的多柔比星，该患者仍存活且未出现心脏毒性，后来还顺利产下一名正常婴儿。虽然有许多研究评估化疗方案相关毒性的治疗，但关于化疗过量及适当应对措施的数据却很少。该病例进一步证实了持续静脉输注多柔比星的心脏毒性较低，并为使用二甲亚砜预防化疗过量毒性提供了支持。
