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Improved survival for patients with advanced carcinoma of the head and neck treated with methotrexate‐leucovorin prior to definitive radiotherapy or surgery.
Author(s) -
Ervin Thomas J.,
Kirkwood John,
Weichselbaum Ralph R.,
Miller Daniel,
Pitman Susan W.,
Frei Emil
Publication year - 1981
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1288/00005537-198107000-00018
Subject(s) - medicine , methotrexate , radiation therapy , head and neck , surgery , carcinoma , oncology
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./m 2 /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 (> 50% reduction in tumor volume) to HD‐MTX are alive and free of tumor >38 months following treatment (p = 0.6) (Fisher Exact Test). Responder median survival is > 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.