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High-dose methotrexate treatment and liver function in patients with osteosarcoma
Journal of Internal Medicine
|August 1, 1994
Summary
Short-term high-dose methotrexate therapy for osteosarcoma may decrease liver reserve capacity, as indicated by reduced galactose elimination. Routine liver function tests remained unchanged, suggesting the need for ongoing liver monitoring in long-term survivors.
Area of Science:
- Oncology
- Hepatology
- Pharmacology
Background:
- Osteosarcoma treatment often involves high-dose chemotherapy.
- Methotrexate is a key chemotherapeutic agent used in osteosarcoma.
- Assessing chemotherapy's impact on liver function is crucial for patient management.
Purpose of the Study:
- To evaluate the effects of short-term, high-dose methotrexate on liver function in osteosarcoma patients.
- To investigate changes in liver reserve capacity and standard liver function tests.
Main Methods:
- An open prospective study was conducted with 14 osteosarcoma patients.
- Patients received high-dose methotrexate (30-57 gm-2) as neoadjuvant chemotherapy.
- Galactose elimination capacity and antipyrine clearance were measured at various time points.
Main Results:
- Galactose elimination capacity significantly decreased after chemotherapy (P = 0.013).
- Routine liver function tests showed no significant changes.
- Antipyrine clearance and half-life remained stable in a subset of patients.
Conclusions:
- High-dose methotrexate therapy can reduce the liver's functional reserve capacity.
- Standard liver function tests may not detect early signs of methotrexate-induced liver dysfunction.
- Long-term monitoring of liver function is recommended for osteosarcoma survivors treated with methotrexate.