Safety comparison of high-dose methotrexate via different intravenous infusion devices in pediatric patients with malignant brain tumors
- VernacularTitle:经不同静脉输液装置给予颅内恶性肿瘤患儿大剂量甲氨蝶呤的安全性比较
- Author:
Xiqiao XU
1
;
Zhengyuan SHI
1
;
Chunjing YANG
1
;
Shumei WANG
1
Author Information
1. Dept. of Pharmacy/Beijing Key Lab for Biometric Evaluation of Clinical Rational Drug Use，Beijing Shijitan Hospital Affiliated to Capital Medical University，Beijing 100038，China
- Publication Type:Journal Article
- Keywords:
methotrexate;
totally implantable venous access port;
peripherally inserted central catheter;
malignant brain tumor
- From:
China Pharmacy
2023;34(7):844-848
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To compare the safety of high-dose methotrexate （HD-MTX） via peripherally inserted central catheter （PICC） and totally implantable venous access port （TIVAP） in pediatric patients with malignant brain tumors. METHODS Patients with malignant brain tumors who received HD-MTX via PICCs or TIVAPs in our hospital from July 2018 to April 2022 were retrospectively analyzed. Clinical data were collected to compare differences in blood concentration of methotrexate （MTX），the incidence of adverse events （including adverse drug reactions and catheter-related complications） and length of stay in hospital. Multivariate linear regression was applied to analyze the factors that influenced the blood concentration of MTX. RESULTS A total of 107 patients were included in the study，with 65 patients in the PICC group and 42 patients in the TIVAP group. Blood concentration of MTX at 24 h （C24 h） in TIVAP group was significantly higher than PICC group （[ 126.87±61.99） μmol/L vs. （102.45±48.77） μmol/L，P＜0.05）. There was no significant difference in blood concentration of MTX at 42 h （C42 h），compared with PICC group （P＞0.05）. Results of multivariate linear regression analysis showed that TIVAP was associated with the increase of C24 h（P＜0.05）. No significant differences were observed in the incidence of adverse events and the length of stay in the hospital between 2 groups （P＞0.05）. CONCLUSIONS Risk of adverse events is not increased，although the MTX C24 h level is elevated after administration of TIVAP. TIVAP is a safe choice for HD-MTX therapy with implementing therapeutic drug monitoring.
