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Methotrexate tolerance in patients with ileal conduits and continent diversions
Author(s) -
Srinivas Sandy,
Mahalati Kamran,
Freiha Fuad S.
Publication year - 1998
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19980315)82:6<1134::aid-cncr18>3.0.co;2-7
Subject(s) - medicine , mucositis , chemotherapy , urinary diversion , methotrexate , surgery , urinary system , cystectomy , toxicity , incidence (geometry) , gastroenterology , bladder cancer , cancer , physics , optics
BACKGROUND Methotrexate is readily absorbed from the intestinal tract. When given to patients with urinary diversion to the intestinal tract, methotrexate may be reabsorbed into the circulation, thus increasing its serum concentration and potentially increasing its toxicity. METHODS Forty‐eight patients with transitional cell carcinoma of the urinary tract who had undergone cystectomy and either an ileal conduit or a continent diversion were evaluated for their tolerance of chemotherapy. Of the 42 evaluable patients, 23 had a continent diversion and 19 had an ileal conduit. None of the patients with the continent diversion had an indwelling Foley catheter during the course of chemotherapy. RESULTS There were no statistically significant differences in incidence of fever or neutropenia, mucositis, dose modification, or delay in chemotherapy between the two groups. When compared with a group of patients with native bladders who received the same chemotherapy, patients with continent diversions did not have increased incidence or severe toxicity from chemotherapy. CONCLUSIONS Patients with continent diversions tolerated chemotherapy as well as patients with ileal conduits. Cancer 1998;82:1134‐6. © 1998 American Cancer Society.