[MTX-BLM therapy for squamous cell carcinoma of the oral cavity]

Effects of Methotrexate (MTX) alone and sequential combination chemotherapy of MTX and Bleomycin (BLM) were evaluated in 29 primary cases of squamous cell carcinoma of the oral cavity. MTX 50mg or 500 mg was administered intravenously once a week for a total dose of 100 to 200 mg in 10 cases and 1000 mg in 19 cases. In the cases of MTX 500 mg, CF (Leucovorin) rescue was given subsequently. BLM 15 mg was also administered intravenously twice a week for a total dose of 45-90 mg in 25 cases, so that 4 patients received MTX alone, 6 were transferred from BLM to MTX treatment and 19 were transferred from MTX to BLM. Objective response rate to MTX in cases of single and prior administration was 12/23 (52.2%). Treatment was found to be effective clinically in cases of exophytic growth type and histologically in cases of well differentiated types of tumor cells and well defined types of tumor-host borderline. Objective response rate to MTX treatment followed by BLM was 12/19 (57.9%) while that of BLM switched to MTX was 3/6 (50.0%). Side-effects, such as myelosuppression and anorexia, were observed in 12/29 cases given MTX, while, in only one case given BLM, skin reaction was observed. With respect to side-effects and the general preoperative condition of patients, the MTX to BLM course seemed to be better than that in which BLM was switched to MTX. Moderate-dose MTX: CF rescue + small-dose BLM therapy for oral cancer was, therefore, concluded to be useful as a preoperative adjuvant chemotherapy.