@article{Tareen_Mahmood_Khan_Tareen_2019, title={EFFICACY OF METHOTREXATE IN THE MANAGEMENT OF LOCALLY ADVANCED AND METASTATIC HEAD AND NECK CANCERS}, volume={69}, url={https://pafmj.org/PAFMJ/article/view/3645}, abstractNote={<p><strong>Objective:</strong> To evaluate the efficacy of single agent methotrexate in locally advanced and metastatic head and neck cancer.</p> <p><strong>Study Design:</strong> Quasi-experimental study.</p> <p><strong>Place and Duration of Study:</strong> Department of Oncology, Combined Military Hospital (CMH), Rawalpindi from Jan 2017 to Jul 2017.</p> <p><strong>Methodology:</strong> 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.</p> <p><strong>Results:</strong> 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.</p> <p><strong>Conclusion:</strong> Single agent methotrexate was an effective alternative regimen for patients with locally advanced or metastatic head and neck cancers.</p>}, number={6}, journal={Pakistan Armed Forces Medical Journal}, author={Tareen, Meherullah and Mahmood, Ahsan and Khan, Muhammad Yousaf and Tareen, Saifullah}, year={2019}, month={Dec.}, pages={1253–57} }