OBJECTIVE Performing a intervention research on preventing oral mucositis afer using high dose methotrexate（MTX） chemotherapy in osteosarcoma by gargling with Calcium folinic（CF）. METHODS Measuring the concentration of methotrexate in saliva by TDX. 189 patients were randomly assigned to four groups：the control group， gargling with CF in advance group， gargling with high dose CF in advance group， gargling with ice water in advance group. Evaluating patients oral mucositis status according to NCCN issued evaluation standard of oral mucositis after chemotherapy. Statistical analysis by SPSS 18.0.RESULTS The concentration of saliva of 21 patients were determinated. Most are 1 × 10-7 mol·L-1 after 28 h. The highest concentration is 3.6 × 10-5mol·L-1. There is a large individual difference.Without giving intervention， The incidence of oral mucositis was 67%. The incidence of mucositis was the lowest in the gargling with ice water in advance group. Mucositis maintains 3-4 d in each group. Gargling with CF in advance group and gargling with ice water group are significantly different.No significant difference between the other groups. CONCLUSION Peak concentration was been found in the beginning of MTX infusion 4-8 h. Plasma concentration down to the level of no cytotoxicity within 48 h of beginning MTX infusion. The most effective METHODS of prevention oral mucositis is the gargling with ice water in advance group.
ZHNG Wei;LI Li-shung;L Yn-wei;ZHEN Jin-cun;ZHNG Xio-lin .
Intervention Research on Preventing Oral Mucositis Afer Using High Dose Methotrexate Chemotherapy in Osteosarcoma by Gargling with Calcium Folinic[J]. Chinese Pharmaceutical Journal, 2011, 46(14): 1126-1128
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参考文献
［1］ WOO S B， SONIS S T， MONOPOLI M M， et al. A longitudinal study oforalul-cerativemucositis in bone marrow transplant recipients［ J］. Cancer， 1993， 72（5）： 1612-1617. ［2］ KNOX J J， PUODXIUNAS A LV ， FELD R. Chemotherapy-induced oral mucositis. Prevention and management. ［J］. Drugs Aging， 2000，17（4）：257-67. ［3］ EPSTEIN J B， TSANG A H， WARKENTIN D， et al. The role of salivary function in modulating chemotherapy-induced oropharyngeal mucositis： a review of the literature［J］. Oral Surg Oral Med OralPathol Oral Radiol Endod， 2002，94（1）：39-44. ［4］ BENSINGER W， SCHUBERT M， ANG K K， et al. NCCN Task Force Report： Prevention and Management of Mucositis in Cancer Care［J］. J Natl Compr Canc Netw， 2008，6（Suppl 1）：S1-21. ［5］ YANG X Y，XU D H. Methylenetetrahydrofolate reductase gene polymorphisms on methotrexate adverse effects［J］. Chin Pharm J（中国药学杂志）， 2007， 42（1）：69-72 ［6］ ISHII E， YAMADA S， HIGUCHI S， et al. Oral mucositis and salivary methotrexate concentration in intermediate-dose methotrexate therapy for children with acute lymphoblastic leukemia［J］. Med Pediatr Oncol， 1989， 17（5）：429-432. ［7］ RASK C， ALBERTIONI F， SCHRODER H， et al. Oral mucositis in children with acute lymphoblastic leukemia after high-dose methotrexate treatment without delayed elimination of methotrexate： relation to pharmacokinetic parameters of methotrexate［J］. Pediatr Hematol Oncol， 1996， 13（4）：313-314. ［8］ OLIFF A， BLEYER W A， POPLACK D G. Methotrexate-induced oral mucositis and salivary methotrexate concentrations. Cancer［J］. Chemother Pharmacol， 1979，2（3）：225-226. ［9］ KANBAYASHI Y， NOMURA K， OKAMOTO K， et al. Statistical examination to determine whether only 48-h value for serum concentration during high-dose methotrexate therapy is a predictor for clinical adverse events using ordered logistic regression analysis［J］. Ann Hematol， 2010，89（10）：965-969. ［10］ HAO J，DUAN F Y，XU W. Nursing on high-dose methotrexate induced serious oral mucositis. ［J］. J North China Coal Med Univ Cell（华北煤炭医学院学报）， 2002， 4（3）：349. ［11］ YANG Q，XU G Z，LI S M. Treatment and nursing on high-dose methotrexate induced IV oral mucositis［J］. Hebei Med J（河北医药）， 2009， 31（2）： 244.
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