Hande K R, Chretien P B, Elias E G, Goldberg N H, Brooks A E, Chabner B A
Med Pediatr Oncol. 1979;6(1):39-45. doi: 10.1002/mpo.2950060106.
Twenty 36-hour infusions of high-dose methotrexate were given preoperatively to 10 patients with head and neck cancer. Plasma methotrexate levels of greater than 1 X 10(-5) M were maintained for 36 hours and declined with primary and secondary plasma half-lives of 1.7 and 9.2 hours following the end of the infusion. Toxicity of this infusion regimen was minimal (10% incidence of significant (WBC less than 2000/mm3) myelosuppression; no renal toxicity) and all patients underwent surgical resection within 3 weeks of therapy without obvious increase in operative complications. Four of ten patients responded to chemotherapy. Further comparison of the therapeutic efficacy of this prolonged preoperative infusion regimen with surgery alone or schedules employing conventional doses or 6-hour infusions of high-dose methotrexate appears warranted.
对10例头颈癌患者术前给予20次36小时的大剂量甲氨蝶呤输注。甲氨蝶呤血浆水平维持在大于1×10⁻⁵ M达36小时，并在输注结束后以1.7小时的初始血浆半衰期和9.2小时的第二血浆半衰期下降。这种输注方案的毒性极小（显著骨髓抑制（白细胞低于2000/mm³）的发生率为10%；无肾毒性），所有患者在治疗后3周内接受了手术切除，手术并发症无明显增加。10例患者中有4例对化疗有反应。将这种延长的术前输注方案与单纯手术或采用常规剂量或6小时大剂量甲氨蝶呤输注方案的治疗效果进行进一步比较似乎是有必要的。
