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Overview of Treatment

This is a general overview of an average patient's treatment (when a patient has a good response to chemotherapy). Each patient's treatment will vary, but this will give you an idea of the standard length of chemotherapy, number of inpatient stays, and the amount of outpatient lab visits. On average, a patient will start off with 10 weeks of chemotherapy and will require an inpatient stay a few days a week during 6 of the 10 weeks. Then, surgery is targeted for week 11, which requires some inpatient stay as well. Finally, treatment ends after 18 more weeks of chemotherapy, with an inpatient stay a few days a week during 12 of the 18 weeks.

MTX Blood Concentrations

You can use this graph to determine how long your hospital stay will last by plotting your MTX blood concentrations. These concentrations can be given to you by your doctor or nurse. Make a mark on the graph at the hour and concentration when the blood was taken. When your MTX blood concentrations fall below the line into the shaded region, you can then be released from the hospital. The average stay length is about 4 days (a little over 72 hours).

Some medications that you may be taking can delay excretion of MTX, causing the blood levels to stay above the desired levels, which would increase the time of hospital stay.
These medications include:

• Organic acids such as salicylates (e.g. Aspirin)
• NSAIDs (e.g. Ibuprofen)
• Sulfa (Antibiotic)
• Penicillins
• Proton pump inhibitors (Drug for stomach ulcers/acid reflux)
• Vitamin C
• Gentomycin (Antibiotic given for fever/neutropenia)
• Vancomycin (Antibiotic given for fever/neutropenia)

If you have taken any of these drugs near the time of receiving MTX, or if you know you will be given MTX soon and another doctor wants to prescribe one of these drugs for symptoms such as fever, etc, let your physician know so that adjustments may be made.