EFFICACY OF METHOTREXATE IN THE MANAGEMENT OF LOCALLY ADVANCED AND METASTATIC HEAD AND NECK CANCERS

Authors

  • Meherullah Tareen Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Ahsan Mahmood Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Muhammad Yousaf Khan Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Saifullah Tareen Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

Keywords:

Head and neck cancer, Methotrexate, Palliative chemotherapy

Abstract

Objective: To evaluate the efficacy of single agent methotrexate in locally advanced and metastatic head and neck cancer.

Study Design: Quasi-experimental study.

Place and Duration of Study: Department of Oncology, Combined Military Hospital (CMH), Rawalpindi from Jan 2017 to Jul 2017.

Methodology: Fifty patients were enrolled with locally advanced or metastatic head and neck cancers, which were unfit for further treatment with curative radical surgery, radiotherapy and/or double agent chemotherapy. All the patients were treated with metronomic chemotherapy methotrexate 50mg weekly intravenously and the dose was escalated as tolerated up to a maximum of 200mg/week. Patients were followed up fortnightly for clinical response using Response Evaluation Criteria in Solid Tumors (RECIST). Imaging was performed on suspicion of progression.

Results: Out of 50 patients, two (4%) patients have shown complete clinical response, 16 (32%) patient with partial response and 19 (38%) patients with stable disease. Disease progression was observed in 13 (26%) patients. Subset analyses revealed thirty-two (64%) patients with improvement in quality of life in terms of symptomatic control. Only 9 (18%) patients were observed with Grade 2 neutropenia, 4 (8%) patients with grade 2 anemia.

Conclusion: Single agent methotrexate was an effective alternative regimen for patients with locally advanced or metastatic head and neck cancers.

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Published

19-12-2019

Issue

Section

Original Articles

How to Cite

1.
Tareen M, Mahmood A, Khan MY, Tareen S. EFFICACY OF METHOTREXATE IN THE MANAGEMENT OF LOCALLY ADVANCED AND METASTATIC HEAD AND NECK CANCERS. Pak Armed Forces Med J [Internet]. 2019 Dec. 19 [cited 2024 Jun. 18];69(6):1253-57. Available from: https://pafmj.org/PAFMJ/article/view/3645