The effect of sequential methotrexate and 5-fluorouracil in patients with recurrent head and neck cancer

Sequential methotrexate and 5-fluorouracil was given to 105 patients with recurrent head and neck cancer. All 105 patients had previously received radiotherapy in curative doses; 41 patients had also been surgically treated and 21 had received previous chemotherapy for recurrence. The treatment consisted of methotrexate 125 mg/m2, followed by 5-fluorouracil 600 mg/m2 after 1 h. Leucovorin rescue was administered after 24 h. A response was observed in 24 patients (23%), including 9 (9%) with complete response. The majority of the responders were patients with a good performance status and with primary tumour in the oropharynx. The toxicity was not negligible, as 5 patients (5%) died of treatment-related causes, mainly due to leukopenia, which was the most frequent and important complication. This sequential methotrexate/5-fluorouracil treatment-schedule cannot be recommended for recurrent head and neck cancer patients.