Moderate-dose methotrexate in head and neck cancer

Area of Science:

• Oncology
• Pharmacology

Background:

• Advanced head and neck cancer presents significant treatment challenges.
• Adjuvant chemotherapy plays a crucial role in managing residual disease and improving outcomes.

Purpose of the Study:

• To evaluate the efficacy and safety of a specific high-dose methotrexate regimen as initial adjuvant therapy for advanced head and neck cancer.
• To assess the response rate, remission rates, and toxicity profile of this treatment approach.

Main Methods:

• A cohort of 38 patients with advanced head and neck cancer received intravenous methotrexate at 200 mg/m2 over 6 hours as initial adjuvant therapy.
• Response rates, complete remission, tumor-free specimens, and toxicity were documented.

Main Results:

• An 80% overall response rate was observed, with 21% achieving complete remission.
• Tumor-free specimens were achieved in 3 patients.
• Toxicity included leukopenia (4), mucositis (6), and diarrhea (1), indicating a manageable safety profile.

Conclusions:

• The studied dose of methotrexate is effective in reducing tumor bulk and appears safe as initial adjuvant therapy for advanced head and neck cancer.
• Leucovorin rescue was generally not required.
• Further randomized trials are needed to establish its impact on long-term survival.