Abstract
Seventy-two patients with advanced squamous-cell carcinomas of the head and neck were randomised to receive weekly intravenous methotrexate at doses of either 50 mg/m2 (low dose), 500 mg/m2 (medium dose), or 5 g/m2 (high dose). Patients who failed to respond after four treatments at their initial dose were given four further treatments at the next higher dose. There were two complete responses and 21 partial responses to the initial dose--in 10 out of 22 patients given the high dose, seven out of 27 given the medium dose, six out of 23 given the low dose. A further five out of 16 patients responded after crossing over to a higher dose. Toxicity was more severe with the high-dose regimen. Responders survived significantly longer than non-responders (p less than 0.05), but there was no significant difference in durations of survival among the three treatment groups. Analysis of patients who completed the first four treatments indicated an improved response rate and duration of survival for the high-dose group. Because of toxicity associated with high-dose methotrexate this treatment produces no overall greater benefit than low-dose regimens.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bell R., Sullivan J. R., Moon W. J., Hurley T. H. High-dose methotrexate therapy. Med J Aust. 1977 Feb 19;1(8):247–249. doi: 10.5694/j.1326-5377.1977.tb130665.x. [DOI] [PubMed] [Google Scholar]
- Bertino J. R., Mosher M. B., DeConti R. C. Chemotherapy of cancer of the head and neck. Cancer. 1973 May;31(5):1141–1149. doi: 10.1002/1097-0142(197305)31:5<1141::aid-cncr2820310515>3.0.co;2-r. [DOI] [PubMed] [Google Scholar]
- Frei E., 3rd, Blum R. H., Pitman S. W., Kirkwood J. M., Henderson I. C., Skarin A. T., Mayer R. J., Bast R. C., Garnick M. B., Parker L. M. High dose methotrexate with leucovorin rescue. Rationale and spectrum of antitumor activity. Am J Med. 1980 Mar;68(3):370–376. doi: 10.1016/0002-9343(80)90105-9. [DOI] [PubMed] [Google Scholar]
- Goldsmith M. A., Carter S. K. The integration of chemotherapy into a combined modality approached to cancer therapy. V. Squamous cell cancer of the head and neck. Cancer Treat Rev. 1975 Jun;2(2):137–158. doi: 10.1016/s0305-7372(75)80007-7. [DOI] [PubMed] [Google Scholar]
- Jaffe N., Frei E., 3rd, Traggis D., Cassady J. R., Watts H., Filler R. M. High-dose methotrexate with citrovorum factor in osteogenic sarcoma--progress report II. Cancer Treat Rep. 1977 Jul;61(4):675–679. [PubMed] [Google Scholar]
- Levitt M., Mosher M. B., DeConti R. C., Farber L. R., Skeel R. T., Marsh J. C., Mitchell M. S., Papac R. J., Thomas E. D., Bertino J. R. Improved therapeutic index of methotrexate with "leucovorin rescue". Cancer Res. 1973 Jul;33(7):1729–1734. [PubMed] [Google Scholar]
- Richard J. M., Sancho H., Brugere J., Vandenbrouck C. Intra-arterial methotrexate in head and neck tumors. Eur J Cancer. 1973 Nov-Dec;9(11-12):847–851. doi: 10.1016/0014-2964(73)90026-1. [DOI] [PubMed] [Google Scholar]
- Von Hoff D. D., Penta J. S., Helman L. J., Slavik M. Incidence of drug-related deaths secondary to high-dose methotrexate and citrovorum factor administration. Cancer Treat Rep. 1977 Jul;61(4):745–748. [PubMed] [Google Scholar]