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Effectiveness of High-Dose Infusions of Methotrexate Followed by Leucovorin in Carcinoma of the Head and Neck¹

Departments of Medicine and Pharmacology, Yale University School of Medicine, New Haven, Connecticut 06510, West Haven Vetterans Administration Hospital, and Department of Surgery, Hartford Hospital, Hartford, Connecticut

Nineteen patients with recurrent carcinoma of the head and neck were treated with three 24-hour infusions of Methotrexate (2 mg/kg) followed by Leucovorin. Maintenance therapy consisted of weekly injections of 0.8 to 1.0 mg/kg of Methotrexate. Nine of 19 patients had objective regression of the disease in the primary site of the tumor and in regional lymph nodes, of which three responses were complete or nearly complete. The mean duration of remission was approximately five months. Mucositis (stomatitis) occurred in five of the nineteen patients, and of these only two were 3rd degree (moderately severe). Leukopenia and thrombocytopenia also generally were mild, although severe depression occurred in three patients, one of whom had a marrow already compromised prior to treatment. High-dose intermittent infusions of Methotrexate followed by Leucovorin seems to be a safe, effective way to induce regression of tumor masses in epidermoid carcinomas of the head and neck.

¹ Supported by Grant CA-08341 from the USPHS and Grant T-403 from the American Cancer Society.

² Supported by Training Grant T01-CA-05138 from the USPHS.

³ Career Development Awardee of the National Cancer Institute.

Received 10/25/67. Accepted 2/18/68.