Summary
The treatment-associated toxicity in 189 patients entered in the COSS-80 Study was analyzed. The sequential use of high-dose methotrexate (HDMTX) with citrovorum factor rescue (CFR) andcis-platinum may be additive or synergistic in causing renal toxicity. However, evaluation of the 48-h serum methotrexate level and the incidence of elevated serum creatinine levels throughout treatment failed to indicate prolonged methotrexate climination or severe kidney damage from this regimen where an interval of 3 weeks betweencis-platinum administration and the next course of HDMTX was mandatory. The treatment-related mortality was 3.2% (6 out of 189 patients). Three patients died of septicemia during chemotherapy-induced bone-marrow depression following treatment with adriamycin or the combination of bleomycin, cyclophosphamide, and dactinomycin (BCD). Three deaths occurred following the use of high-dose methotrexate with citrovorum factor rescue. Two of these deaths were associated with delayed excretion of methotrexate. The toxicity is within the range reported in the literature.
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Jürgens, H., Beron, G. & Winkler, K. Toxicity associated with combination chemotherapy for osteosarcoma: A report of the cooperative osteosarcoma study (COSS 80). J Cancer Res Clin Oncol 106 (Suppl 1), 14–18 (1983). https://doi.org/10.1007/BF00625045
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DOI: https://doi.org/10.1007/BF00625045