Adjuvant intravenous methotrexate or definitive radiotherapy alone for advanced squamous cancers of the oral cavity, oropharynx, supraglottic larynx or hypopharynx

Journal Article · Thu May 01 04:00:00 EDT 1980 · Int. J. Radiat. Oncol., Biol. Phys.; (United States)

DOI:https://doi.org/10.1016/0360-3016(80)90379-X· OSTI ID:6773254

Fazekas, J T ^[1]; Sommer, C; Kramer, S

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1. Thomas Jefferson Univ. Hospital, Philadelphia, PA

Three hundred twenty-six patients with advanced head and neck cancers were randomized to receive definitive radiotherapy alone while 312 similar patients first received intravenous Methotrexate. No significant bias was demonstrated between the two patient populations. The number of annual deaths among the two randomized categories was essentially equal during the first 5 years. Nearly one-half occurred in the first year (146 for radiation alone and 143 in the chemotherapy plus irradiation groups). Median metastasis-free survival was between 12 to 13 months in both categories. The unadjusted 5 year survivals were in the 11 to 22% range for oral cavity, oropharynx, and supraglottic larynx and 3 to 9% for hypopharynx primaries. Although several variables did exert an impact upon survival, primary (T) and lymph node (N) stage seem to be of paramount importance and Methotrexate of minor consideration. Median and 5-year survivals within the various anatomic regions were consistently better when Methotrexate was given. However, these improvements were minimal and depended upon whether comparisons were performed on adjusted or unadjusted survival figures. In view of the modest benefits attained by using this Methotrexate regimen the authors suggest that other adjuvant programs be investigated and that this schedule not be adopted for routine clinical usage.

• OSTI ID: 6773254
• Journal Information: Int. J. Radiat. Oncol., Biol. Phys.; (United States), Journal Name: Int. J. Radiat. Oncol., Biol. Phys.; (United States) Vol. 6:5; ISSN IOBPD
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
ANTIMETABOLITES
ANTIMITOTIC DRUGS
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
CHEMOTHERAPY
COMPARATIVE EVALUATIONS
DATA
DIGESTIVE SYSTEM
DISEASES
DRUGS
EXPERIMENTAL DATA
INFLAMMATION
INFORMATION
LARYNX
MEDICINE
MEMBRANES
METHOTREXATE
MORTALITY
MUCOUS MEMBRANES
NEOPLASMS
NUCLEAR MEDICINE
NUMERICAL DATA
ORAL CAVITY
ORGANS
PATHOLOGICAL CHANGES
PATIENTS
PHARYNX
RADIATION EFFECTS
RADIOINDUCTION
RADIOLOGY
RADIOSENSITIVITY EFFECTS
RADIOTHERAPY
RESPIRATORY SYSTEM
SIDE EFFECTS
SURVIVAL CURVES
THERAPY
TIME DEPENDENCE