Methotrexate Revisited—in Recurrent Head and Neck Cancer

Aims Response of single agent chemotherapy in improving quality of life in patients with recurrent head and neck cancers. Methods and material This is a study of the 18 patients with advanced cancers of head and neck, who had failed earlier attempts of radical treatment with Surgery, Radiotherapy ±...

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Main Authors: R.P.S. Banipal, M.K. Mahajan
Format: Article
Language:English
Published: SAGE Publishing 2011-01-01
Series:Palliative Care
Online Access:https://doi.org/10.4137/PCRT.S6107
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spelling doaj-2f728fd62bf74b44ba7063b74df15fdc2020-11-25T02:52:30ZengSAGE PublishingPalliative Care1178-22422011-01-01510.4137/PCRT.S6107Methotrexate Revisited—in Recurrent Head and Neck CancerR.P.S. Banipal0M.K. Mahajan1Department of Radiation Oncology, Christian Medical College, Ludhiana, Punjab, India.Department of Radiation Oncology, Christian Medical College, Ludhiana, Punjab, India.Aims Response of single agent chemotherapy in improving quality of life in patients with recurrent head and neck cancers. Methods and material This is a study of the 18 patients with advanced cancers of head and neck, who had failed earlier attempts of radical treatment with Surgery, Radiotherapy ± chemotherapy and have residual or recurrent tumours, were treated with single agent Injection Methotrexate 50 mg/m 2 weekly. Follow up visit complaints and clinical examination details were recorded. History regarding pain, speech and diet was collected for every visit. Severity of pain was divided with the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 pain scales. Symptom control was done with analgesics, antiemetic and infection control. Results Weekly single agent chemotherapy with injection Methotrexate has significantly improved the quality of life of patients. 38.8% of patients have shown good response with decrease in the tumour bulk by more than 50% and other 39% of patients have stable disease on Injection Methotrexate. 22.2% patients have shown disease progression on single agent chemotherapy. Overall 83.3% patients have shown improvement in Quality of life in terms of symptomatic control. After 6 weekly treatments with injection methotrexate 63% patients were pain free with 16% patients reported decrease in pain. 87.5% of patients have shown improvement in speech and diet. Improvement in symptoms has shown decrease in depression in cancer patients. Grade 3 toxicity observed was Neutropenia (11.1%), anaemia (11.1%) and Mucositis (16.6%) which was managed adequately. Median survival with good quality of life is 5.4 months. Conclusions Single agent methotrexate chemotherapy on an out-patient basis can provide good quality of life. Decrease in pain along with improvement in speech and diet has shown decrease in incidence of depression and overall positive impact on psychosocial status. Few cases have shown sustained regression of gross disease adding to maintained quality of life with better socio-economic compliance.https://doi.org/10.4137/PCRT.S6107
collection DOAJ
language English
format Article
sources DOAJ
author R.P.S. Banipal
M.K. Mahajan
spellingShingle R.P.S. Banipal
M.K. Mahajan
Methotrexate Revisited—in Recurrent Head and Neck Cancer
Palliative Care
author_facet R.P.S. Banipal
M.K. Mahajan
author_sort R.P.S. Banipal
title Methotrexate Revisited—in Recurrent Head and Neck Cancer
title_short Methotrexate Revisited—in Recurrent Head and Neck Cancer
title_full Methotrexate Revisited—in Recurrent Head and Neck Cancer
title_fullStr Methotrexate Revisited—in Recurrent Head and Neck Cancer
title_full_unstemmed Methotrexate Revisited—in Recurrent Head and Neck Cancer
title_sort methotrexate revisited—in recurrent head and neck cancer
publisher SAGE Publishing
series Palliative Care
issn 1178-2242
publishDate 2011-01-01
description Aims Response of single agent chemotherapy in improving quality of life in patients with recurrent head and neck cancers. Methods and material This is a study of the 18 patients with advanced cancers of head and neck, who had failed earlier attempts of radical treatment with Surgery, Radiotherapy ± chemotherapy and have residual or recurrent tumours, were treated with single agent Injection Methotrexate 50 mg/m 2 weekly. Follow up visit complaints and clinical examination details were recorded. History regarding pain, speech and diet was collected for every visit. Severity of pain was divided with the National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 pain scales. Symptom control was done with analgesics, antiemetic and infection control. Results Weekly single agent chemotherapy with injection Methotrexate has significantly improved the quality of life of patients. 38.8% of patients have shown good response with decrease in the tumour bulk by more than 50% and other 39% of patients have stable disease on Injection Methotrexate. 22.2% patients have shown disease progression on single agent chemotherapy. Overall 83.3% patients have shown improvement in Quality of life in terms of symptomatic control. After 6 weekly treatments with injection methotrexate 63% patients were pain free with 16% patients reported decrease in pain. 87.5% of patients have shown improvement in speech and diet. Improvement in symptoms has shown decrease in depression in cancer patients. Grade 3 toxicity observed was Neutropenia (11.1%), anaemia (11.1%) and Mucositis (16.6%) which was managed adequately. Median survival with good quality of life is 5.4 months. Conclusions Single agent methotrexate chemotherapy on an out-patient basis can provide good quality of life. Decrease in pain along with improvement in speech and diet has shown decrease in incidence of depression and overall positive impact on psychosocial status. Few cases have shown sustained regression of gross disease adding to maintained quality of life with better socio-economic compliance.
url https://doi.org/10.4137/PCRT.S6107
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