Treatment of advanced head and neck carcinoma with synchronous irradiation and methotrexate

Thirty-four patients with advanced head and neck cancer were treated by synchronous radiotherapy and methotrexate (MTX) (100 mg/m2). Complete resolution of disease was obtained in 18 patients, the median remission of patients being 17 months. In general, treatment was well tolerated, although mucosal reaction was prolonged in 50% of patients. Drug-induced hematological toxicity was observed in six patients (18%) and one patient died. As a result of these findings, a random clinical trial to compare X-ray therapy with X-ray therapy and MTX in advanced head and neck cancer has been commenced.