Kohorn E I
Department of Obstetrics & Gynecology, Yale University School of Medicine, New Haven, Connecticut 06510.
Gynecol Oncol. 1993 Sep;50(3):300-4. doi: 10.1006/gyno.1993.1215.
Methotrexate serum levels were measured in eight patients receiving etoposide, methotrexate, actinomycin, cyclophosphamide, and oncovin (EMA-CO) chemotherapy for high-risk and actinomycin-resistant gestational trophoblastic neoplasia. During 41 courses of EMA there were only 3 instances where the level of methotrexate was greater than 9 x 10(-7) M/liter at 24 hr postinfusion. A level higher than this may be associated with subsequent toxicity. Use of postmethotrexate leucovorin rescue should continue, but routine measurement of methotrexate with EMA-CO is unnecessary unless there is compromise of renal or hepatic function.
对8例接受依托泊苷、甲氨蝶呤、放线菌素、环磷酰胺和长春新碱（EMA-CO）化疗的高危及放线菌素耐药性妊娠滋养细胞肿瘤患者测定了甲氨蝶呤血清水平。在41个EMA疗程中，仅3例在输注后24小时甲氨蝶呤水平大于9×10⁻⁷摩尔/升。高于此水平可能与后续毒性相关。甲氨蝶呤后亚叶酸钙解救仍应继续使用，但除非存在肾功能或肝功能损害，否则常规用EMA-CO测定甲氨蝶呤并无必要。
