PP139: Outcome of intravenous methotrexate in recurrent or persistent squamous cell carcinoma of head and neck

Abstract

Recurrence or progressive disease in head and cancers is considered to have poor prognosis. Although various chemotherapeutic agents have been tried in palliative settings but there is a lack of definitive standard protocol. The aim of this retrospective study is to evaluate the outcome of methotrexate in recurrent or persistent squamous cell carcinoma of head and neck in our institution. Between January 2006 to December 2009, 103 patients with recurrent or persistent head and neck cancers were identified from Head and Neck Database at Shaukat Khanum Memorial Cancer Hospital and Research Center. All the patients had good performance status (ECOG 0–1) prior to the start of palliative chemotherapy. All the patients received intravenous methotrexate 40 mg/m 2 weekly. Response, toxicity and mean time to progression were determined. Response to methotrexate; complete response (CR) in 10 (10%), partial response (PR) in 11 (11%), stable disease (SD) in 60 (60%) and progressive disease (PD) in 19 (19%) of patients respectively. Chemotherapy related toxicity were; grade 4 febrile neutropenia in 6 (5%), grade 4 mucositis in 6 (5%), deranged liver functions in 17 (16%) patients. Mean time to progression was 7.5 months (range: 1–39 months). The disease control in our study is comparable in the already published literature. Although various drug regimens have been employed in the past very little has been gained in slowing the progression of the disease.