Stutz F H, Tormey D C, Blom J
Can Med Assoc J. 1973 Mar 17;108(6):710-4.
Seventeen patients with metastatic breast carcinoma were treated with a combination of 5-fluorouracil, methotrexate, vincristine, cyclophosphamide and prednisone. Six of the patients (35%) developed a syndrome consisting of fever, malaise, dyspnea, hypoxemia and bilateral pulmonary interstitial infiltrates from 41 to 148 days after institution of therapy. The syndrome varied from a mild to a life-threatening illness with recovery in 10 to 60 days. It is believed that these cases represent examples of methotrexate-induced pneumonitis. The high incidence of the syndrome in this patient group may be related to the concomitant administration of cyclophosphamide with methotrexate. The observations also suggest that patients with previous adrenalectomies may have pneumonitis with an especially severe and protracted course.
17例转移性乳腺癌患者接受了5-氟尿嘧啶、甲氨蝶呤、长春新碱、环磷酰胺和泼尼松联合治疗。6例患者（35%）在治疗开始后41至148天出现了一种综合征，包括发热、不适、呼吸困难、低氧血症和双侧肺间质浸润。该综合征的严重程度不一，从轻度到危及生命，10至60天内恢复。据信这些病例代表了甲氨蝶呤诱发的肺炎。该患者组中该综合征的高发病率可能与环磷酰胺与甲氨蝶呤同时给药有关。这些观察结果还表明，既往接受过肾上腺切除术的患者可能发生肺炎，且病程特别严重和迁延。
