No abstract

Eleven patients with squamous carcinoma of the head and neck who were scheduled for surgical resection or endoscopic biopsy of tumor received 15 mg/m2 of methotrexate (MTX). Samples of tumor, normal mucosa, and plasma were obtained at surgery or endoscopy, 18-24 hours after the last MTX dose. Tissue content and plasma concentration of MTX and folate were measured using sequential radioligand-binding assays. Median MTX content was 50.0 pmol/g wet weight in tumor, 19.0 in normal mucosa, and < 0.5 nM (pmol/ml) in plasma. Since dihydrofolate reductase (DHFR) content of human tumors has previously been shown to be less than 5 pmol enzyme/g wet weight, tumor MTX content exceeded expected DHFR content in all but one patient. These data support the concept that low doses of MTX saturate tumor DHFR and that, in this regard, dose escalation may have limited value.

A progressive trend toward increased occurrence of head and neck cancer in women is reported. Over the most recent 6 year period, 533 newly diagnosed patients were referred for treatment of head and neck cancer; 169 (32%) were women. Review of their cases showed heavy use of tobacco and alcohol by many of these women patients. The acceptance of the use of these mucosal irritants and changing social mores in the tobacco belt society under study predate recent national trends of similar nature. Thus, the increased incidence of head and neck cancer in women reported here probably presages similar increases in that incidence nationwide.