Tratamento de Vários Ttipos de Tumores Sólidos com Infusão Contínua, Intrarterial, de Solução de “Methotrexate” Associada à Administração Simultânea e Descontínua do Fator Citrovorum e Complementação pela Telecobaltoterapia
DOI:
https://doi.org/10.32635/2176-9745.RBC.1964v20n26.3746Keywords:
Methotrexate/therapeutic use, Methotrexate/analysis, Neoplasms/drug therapy, Neoplasms/therapyAbstract
The intra-arterial infusion of Methotrexate is extremely usefull in the treatment of advanced head and neck cancer. We have obtained complete regression of the tumor in two patiens with far advanced carcinoma of the antrum and in one with squamous cell carcinoma of the tongue. One of the patients is still living and without evidence of disease after 24 months of a single intra-arterial infusion of 125 mg. of Methotrexate complement by local telecobaltotherapv. This person is now in the 5th month of a normal pregnancy. Another patient with the same type of neoplasm had complete remission of the disease and died 15 months later of unrelated disease. Paliation of variable duration was obtained in 60% of the cases, but in 20% of the patients it lasted less than a month. In this trial treatment, conservative doses were employed due to the difficulty of obtaining injectable MXT and C. F. in this country and to the high cost of the treatment which makes it almost impracticable in Brasil at the present time. We feel that with higher doses of MXT we could better our end results. On the other hand, the best responses were achieved in patients treated which 125 mg. of MXT givens in five days. Although MXT may enchance the effects of radiation we were interested when we have associated both treatments in the sommation of effects rather than in enbancement. From our experience, telecobaltotherapy is a necessary complement of intra-arterial MXT therapy which permits consolidation of the good initial results that otherwise are of only a short duration.
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References
FARBER, S.; DIAMOND, L. K.; MERCER, R. D.; SYLVESTER, R. F. J.; and WOLFF, J. A. “Temporary remissions in acute leukemia in children produced by folie acid antagonist, 4-aminopteroyl-glutamic acid (Aminopterin) ”. New England J. Med. 238: 787, 1948. DOI: https://doi.org/10.1056/NEJM194806032382301
WRIGHT, L.T.; PRIGOT, A.; WRIGHT, B. P.; WRIGHT, J. C.; and HJELT, I. — “Chemotherapy of leukemia in adults”. Harlem Hosp. Bull., N. Y. 4: 91-113, 1951.
FARBER, S. — “Some observations on the effect of folie acid antagonists on acute leukemia and other forms of incurable cancer”. Blood 4: 160-167, 1949. DOI: https://doi.org/10.1182/blood.V4.2.160.160
THIERSCH, J. B. — “Bone marrow changes in man after treatment with Aminopterin, A-Methopterin and Aminoanfol; with special reference to megaloblastosis and tumor remission”. Cancer 2: 877-883, 1949. DOI: https://doi.org/10.1002/1097-0142(194909)2:5<877::AID-CNCR2820020520>3.0.CO;2-0
WRIGHT, J. C.; PRIGOT, A.; WRIGHT, B. P.; WEINTRAUB, S.; and WRIGHT, L. T. — “An evaluation of folie acid antagonists in adults with neoplastic diseases: A study of 93 patients with incurable neoplasm”. J. Nat. M. Assoc. 43: 211-240, 1951.
BURCHENAL, J. H.; KARNOFSKY, D. A.; KINGSLEY PILLERS, E. M.; SOUTHAM, C. M.; MYERS, W. P. L.; ESCHER, G. C.; CRAVER, L. F.; DARGEON, H. W.; and THOADS, C. P. — “The effects of the folie acid antagonists and 2, 6-diaminopurine on neoplastic disease; with special reference to acute leukemia”. Cancer 4: 549, 1951. DOI: https://doi.org/10.1002/1097-0142(195105)4:3<549::AID-CNCR2820040308>3.0.CO;2-J
SHOENBACH, E. B.; COLSKY, J.; and GREENSPAN, E. M. — “Observations on the effects of the folie acid antagonists, Aminopterin and A-Methopterin in patients with advanced neoplasms”. Cancer 5: 1201-1220, 1952. DOI: https://doi.org/10.1002/1097-0142(195211)5:6<1201::AID-CNCR2820050617>3.0.CO;2-1
Proc. 2d Conf. on Folie Acid Antagonists in Leukemia. Bethel F. H., pp. 119-124, 183-185; WRIGHT, J. C., pp. 178-181; GUBILLIGAN, J. J., Jr., pp, 133-136; PRIGOT, A., pp. 185-183. Blood 7, 1952.
WRIGHT, J. C.; GUMPORT, COLOMB, F. M. “Remissions produced with the use of Methotrexate in Patients with Mycosis Fungoides”. Cancer Chem. Reports pp. 11-22, (Nov.), 1960.
WITTEN, V. H. (Discussion) “Mycosis Fungoides”. Arch. Dermatol. 83: 1052-1053, (June), 1961. DOI: https://doi.org/10.1001/archderm.1961.01580080047005
LEIDER, M.; and WRIGHT, J. C. (Discussion) — “Mycosis Fungoides”. Arch. Dermatol. 84: 163-164 (July), 1981.
BERSANI, R. (Discussion) — “Diagnosis: Mycosis Fungoides”. Arch. Dermatol. 81: 410 (March), 1960.
VAN SCOTT, E. J.; SHAW, R. K.; CROUNSE, R. G.; and CONDIT, P. T. — “Effects of Methotrexate on Basalcell Carcinomas”. A. M. A. Arch. Dermatol. 82: 762-771 (Nov.), 1960. DOI: https://doi.org/10.1001/archderm.1960.01580050104016
MIN CHIU LI; ROY HERTZ; and DONALD, B. SPENCER — National Institute of Health, U. S. Public Health Service, Betheada, MD. “Effect” of Methotrexate Therapy upon Choriocarcinoma and Chorioadenoma (22757). Proc. Soc. Exper. Biol. & Med. 93: 361-366, 1956. DOI: https://doi.org/10.3181/00379727-93-22757
SULLIVAN, R.D.; MILLER, E.; SYKES. M. P. — “Antimetabolite combination cancer chemotherapy. Effects of intra-arterial Methotrexate-intramuscular Citrovorum Factor therapy in human cancer”. Cancer, 12: 6, p. 1248-1262, Nov.-Dec., 1959. DOI: https://doi.org/10.1002/1097-0142(195911/12)12:6<1248::AID-CNCR2820120619>3.0.CO;2-2
ROBERT D. SULLIVAN; EDWARD MILLER; A. MICHAEL WOOD; PETER CLIFFORD; JOHN K. DUFF; RICHARD TRUSSELL; and JOSEPH H. BURCHENAL — ““Continuous infusion cancer chemotherapy in humans — Effects of therapy with intra-arterial Methotrexate plus intermittent intramuscular Citrovorum Factor”. Cancer Chemotherapy Reports, 10, December, 1960.
ROBERT D. SULLIVAN; A. MICHAEL WOOD; PETER CLIFFORD; JOHN K. DUFF; RICHARD TRUSSELL; DOROTHY K. NARY; and JOSEPH H. BURCHENAL— “Continuous intra-arterial Methotrexate with simultaneous, intermittent, intramuscular Citrovorum Factor therapy in Carcinoma of the cervix”. Cancer Chemotherapy Reports 8: pp. 1-6, July, 1960.
ROBERT D. SULLIVAN, M. D. — Arterial Infusion Therapy Lecture presented in Several Countries in the Far East in December 1962”.
LIGUORI, V. R.; GTGLIO, J. J.; MILLER, E.; and SULLIVAN, R. D. — “The effects of different dosage schedules of Methotrexate on sera and tissue levels and urinary excretion patterns”. Clin. Pharm. & Therapy 3: 34-40 (Jan.-Feb.), 1962. DOI: https://doi.org/10.1002/cpt19623134
BURCHENAL, J. H.; CREMER, M. A.; WILLIAMS, B. S.; and ARMSTRONG, R. A. — Sterilization of leukemic cells “in vivo” and “in vitro”. Cancer rep. 11: 700-705 (Sept.), 1951.
MBNDELSOHN, M. L. “Chronic infusion of tritiated thymidine into mice with tumors”. Science 135-213-21 215 (Jan. 19), 1962. DOI: https://doi.org/10.1126/science.135.3499.213
BURCHENAL, H. H.; WARING, G. B.; ELLISON, R. R.; and REILLY, H. C. — “Simple method for Determination of Levels of Amethopterin in Blood and Urine”. Proc. Soc. Exp. Biol. Med. 78: 603-606 (1951). DOI: https://doi.org/10.3181/00379727-78-19154
FREEMAN, N. M. — Fluorometric Measurements of the Absorption, Distribution and Excretion of Single Doses of 4-Amino-lO-Methyl-Pteroyl glutamic acid (Methotrexate) J. Pharmacol. Exp. Ther. 122: 154-162 (Jan.), 1958.
FREEMAN, N. M., in “Methotrexate in the Treatment of Cancer”, Williams and Wilkins Co., 1962.
HUENNEKENS, F. M.; and OSBORN, M. J. — “The role of Dihydrofolic Reductase in the Metabolism of the one-carbon units”. Biochem. J. 2 (1): 151-159, 1983. DOI: https://doi.org/10.1021/bi00901a027
HUENNEKENS, F. M.; and OSBORN, M. J. — Folic acid coenzymes and one carbon metabolism”. Advances Enzymol. 21: 309, 1959. DOI: https://doi.org/10.1002/9780470122662.ch8
FRIEDKIN, M.; and ROBERTS, D. — “Conversion of uracil deoxyriboside to thymidine of deoxyribonucleid acid”. J. Biol. Chem. 220: 653, 1956. DOI: https://doi.org/10.1016/S0021-9258(18)65290-1
STOVENER J.; ENGSETHT, A.; and BOREMHOOD, I. — “Cancer Therapy by Intra-arterial Methotrexate Infusion. Protection of Mucous Membrances by Topically Applied Citrovorum Factor with Hyaluromidase”. Cancer. Chem. Reports 21: 147-148, 1962.
WESTBURY, G. — “Continuous Intra-Arterial Infusion and Intermittent Intra-arterial Injection”. Proc. of the Roal Soc. of Med. 58: 655-656 (Aug.), 1963. DOI: https://doi.org/10.1177/003591576305600809
FRIDMAN, MILTON, DALY, JOHN F. — “Combined Irradiation and Chemotherapy in the Treatment of Squamous Cell Carcinoma of the Head and Neck”. Am. J. of Roent. 90: 246-259, 1963.
