Summary
- In a study of cancer patients treated with methotrexate (MTX) at Siriraj Hospital, 5.22% of patients developed neurotoxicity, with a higher prevalence in pediatric patients compared to adults.
- Pediatric patients primarily presented with acute encephalopathy, hemiparesis, seizures, and altered mental status, while adults exhibited varied symptoms including myelopathy and radiculopathy.
- Neurotoxicity rates differed based on MTX administration routes, with intravenous administration associated with higher odds of neurotoxicity compared to intrathecal or combined routes in both pediatric and adult patients.
- Imaging findings showed distinct brain lesion locations and progression patterns, with some patients developing disseminated necrotizing leukoencephalopathy.
- The outcomes of MTX-associated neurotoxicity varied, with a majority of patients improving or remaining stable, and no recurrent episodes reported in patients who continued MTX treatment following neurotoxicity.
A recent study conducted at Siriraj Hospital has found that a small percentage of cancer patients treated with a medication called MTX experienced neurotoxicity, which is a condition affecting the nervous system. The study analyzed data from 498 patients and identified that 5.22% of them developed neurotoxicity. It was noted that pediatric patients had a higher prevalence of neurotoxicity compared to adults.
The symptoms of neurotoxicity varied between pediatric and adult patients. Pediatric patients mainly presented with encephalopathy, while adult patients had a wider range of symptoms including myelopathy and radiculopathy. Interestingly, no pediatric patients exhibited chronic neurotoxicity, while this was observed in some adult patients.
The study also looked at the administration routes of MTX and found that the method of administration impacted the likelihood of developing neurotoxicity. Intravenous administration was associated with higher rates of neurotoxicity compared to intrathecal administration.
In terms of outcomes, the study found that a majority of patients with MTX-associated neurotoxicity improved or remained stable. Patients who received rescue therapies showed improvement, highlighting the importance of timely intervention.
Overall, this study sheds light on the prevalence, clinical presentations, and outcomes of MTX-associated neurotoxicity in cancer patients. Further research in this area could help improve treatment strategies and outcomes for these patients.
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Neurology, Oncology, Pharmacists