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Related Experiment Videos

Methotrexate osteopathy in patients with osteosarcoma

K Ecklund1, T Laor, A M Goorin

  • 1Department of Radiology, Children's Hospital, Harvard Medical School, Boston, Mass, USA.

Radiology
|February 1, 1997
PubMed
Summary

Osteopathy, a skeletal complication, affects about 9% of children with osteosarcoma treated with high-dose methotrexate. Younger patients are significantly more prone to this adverse effect.

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Area of Science:

  • Pediatric Oncology
  • Skeletal Radiology
  • Pharmacology

Background:

  • High-dose methotrexate is a critical treatment for osteosarcoma.
  • Potential skeletal complications associated with methotrexate therapy require investigation.
  • Understanding treatment-related toxicities is crucial for patient management.

Purpose of the Study:

  • To determine the frequency of osteopathy in osteosarcoma patients receiving high-dose, short-term, intravenous methotrexate.
  • To assess if osteopathy incidence varies with patient age and methotrexate dose.

Main Methods:

  • Retrospective review of radiographs and scintigrams from 87 osteosarcoma patients treated with high-dose methotrexate.
  • Diagnosis of osteopathy required at least three radiographic abnormalities: severe osteopenia, dense zones of provisional calcification, insufficiency fractures, or multiple bone involvement.

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  • Exclusion of patients with bone metastases.

    • Main Results:

    • Eight patients (9%) developed osteopathy, with cumulative doses ranging from 60-144 g/m2.
    • Radiographic findings included severe osteopenia, dense zones of provisional calcification, multiple bone involvement, and insufficiency fractures.
    • Younger patients (mean age 9.2 years) were significantly more likely to develop osteopathy than older patients (mean age 14.9 years).

    Conclusions:

    • Osteopathy occurs in approximately 9% of pediatric osteosarcoma patients treated with high-dose methotrexate.
    • Younger patient age is a significant risk factor for developing methotrexate-induced osteopathy.
    • The complication rate did not appear to be directly dependent on the methotrexate dose.