Improved survival for patients with advanced carcinoma of the head and neck treated with methotrexate-leucovorin prior to definitive radiotherapy or surgery

The Laryngoscope
T J ErvinE Frei

Abstract

Patients presenting with Stage III-IV squamous carcinoma of the head and neck often relapse following aggressive surgery and/or radiotherapy. In an attempt to increase survival in this high risk group of patients, HD-MTX, 3 gm./m2/dose, given weekly, was administered to 21 inoperable patients with Stage III/IV squamous carcinoma of head and neck prior to, and for 1 month after, definitive surgery and/or radiotherapy. Six of 11 patients (55%) who showed a significant response (greater than 50% reduction in tumor volume) to HD-MTX are alive and free of tumor greater than 38 months following treatment (p = 0.6) (Fisher Exact Test). Responder median survival is greater than 38 months while non-responder median survival is 15 months (p = .02) (Log Rank Test). For the entire treatment group, at a mean duration of 44.2 months following initiation of therapy, 7 patients (33%) remain alive and free of tumor. Patients responding to induction MTX-LCV more often become eligible for combined modality approach than did the non-responder group. This "downstaging" of the tumor prior to aggressive surgery or radiotherapy may be responsible for the increased survival rate seen in those patients who responded to MTX-LCV.

Citations

Nov 5, 1997·American Journal of Clinical Oncology·R S Hughes, E P Frenkel
Jun 1, 1983·Clinical Otolaryngology and Allied Sciences·J HibbertO H Shaheen
Jan 1, 1984·Critical Reviews in Oncology/hematology·M Al-Sarraf
Jul 1, 1982·The Annals of Otology, Rhinology, and Laryngology·R R WeichselbaumD Miller
Jan 2, 1982·British Medical Journal·J E Husband, S J Golding

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