After high-dose treatments, the body reacts, sometimes quite severely.
Dr. Straus said the likelihood of a recurrence with Ms. Borgatti is high without the high-dose treatment.
Methotrexate formulations with preservatives must not be used for high-dose treatment or injected into the spine (intrathecal).
"You give this high-dose treatment, which you can't give otherwise, and hopefully kill the remaining cancer cells in his body," Dr. Ozkaynak said.
As in other inflammatory diseases, steroids may be used first of all, either as a short course of high-dose treatment, or in a lower dose for long-term treatment.
The researchers found that high-dose treatment with opioids provided much greater chronic pain relief than lower doses of the drug.
All groups who use radiation advocate high-dose treatment to the primary site and to both sides of the neck to include the retropharyngeal and lateral cervical nodes.
Physical and/or psychological dependence can occur, and withdrawal effects are possible if the medication is stopped suddenly after prolonged or high-dose treatment.
The worry is that some high-dose treatments may be limited by the radiation toxicity capacity of healthy tissues which lay close to the target tumor volume.
The trial compares the potential benefits of a stem cell transplant with high-dose monthly treatment with cyclophosphamide, a chemotherapy drug given for chronic immunosuppression.
