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융모성상피암에 있어서의 Methotrexate 포화검사의 의의
김승조 ( SJ Kim ),송승규 ( SK Song ),이헌영 ( HY Lee ),정재근 ( JK Jung ),안웅식 ( WS An ),최원영 ( WY Choi ) 대한산부인과학회 1991 Obstetrics & Gynecology Science Vol.34 No.7
The clinical pharmacology of methotrexate, administered in conventional intravenous doses, has been studied extensively in man utilizing a variety of assay techniques. However, only a few studies have been undertaken to investigate the pharmacology of intermediate doses of methotrexate followed by delayed rescus with citrovorum factor. So, we have got following conclusion, which is drawn by methotrexate saturation test. With that, we may eliminate drug resistance which can be the main problem in methotrexate chemotherapy and we can figure it out the proper timing or dosage of leucovorin rescue for more efficient anticancer chemotherapy. The results as follows; 1. Methotrexate serum level reaches up to the highest point in 30 minutes after the intravenous infusion, and 5.04±2.05 hour is its half life. 2. In case leucovorin rescue is used, we give it folic acid 30mg, without regarding methotrexate serum level, within 24 and 48 hours after methotrexate intravenous infusion. 3. During the methotrexate chemotherapy, the relation with drug toxicity and half life remains longer than average, the drug toxicity is a not stronger. But there seems no strict statistical significance. In case of hepatotoxicity, there is no special difference between the drug toxicity of methotrexate chemotherapy and the serum level after 48 hours of methotrexate intravenous infusion. But in case of hematologic toxicity, the group of higher methotrexate serum level appear a stronger toxicity than the lower methotrexate serum level group. Therefore, authors made it a conclusion that methotrexate saturation test should be done to identify patients who would react to the drug toxicity in case of anticancer chemotherapy of methotrexate, and to administate the proper leucovorin rescue for preventing drug toxicity.
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