Abstract
Context: Palliative fortnightly chemotherapy in oral cancers. Aims: We present our experience with a regimen employing fortnightly (once in 2 weeks)
injectable methotrexate (MTX) (40 mg/m 2 ) in a predominantly elderly cohort of patients with carcinoma of oral cavity and
oropharynx. Settings and Design: Retrospective chart review conducted at a rural cancer center in India. Materials and Methods: All patients with oral cavity and oropharyngeal cancers started on treatment with
fortnightly injectable MTX (40 mg/m 2 ) between 01/01/2011 and 31/12/2011. Statistical Analysis Used: The factors analyzed included the duration of disease control, pain control, overall
survival and progression free survival which were evaluated using the Kaplan Meier
method. Results: A total of 60 patients with a median age of 66.5 years were analyzed. Majority of
the patients had poor nutritional status, performance status or co-morbidities. MTX
was given for recurrent disease in 19 patients and after initial palliative radiotherapy
in 41 patients. The median number of cycles delivered was nine. Grade 3/4 toxicities
were seen in 2 patients only. Disease control rate at the end of treatment was seen
in 33 (55%) patients. Median overall survival was 34 weeks (interquartile range: 17-50
weeks). Conclusions: The fortnightly regimen of MTX was well-tolerated and showed a good clinical activity
in this elderly cohort of patients with advanced oral cavity and oropharyngeal cancers.
Key words
Methotrexate - oral cancer - palliative chemotherapy - squamous cell cancers
