Treatment of Cancer of the Head and Neck by Chemotherapy

Beahrs, Oliver H.; Caldarola, Vincent T.; Harrison, Edgar G.

doi:10.1001/jama.1964.03070100059012

Cited by 5 publications

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Chemotherapy of cancer of the head and neck

Bertino

Mosher

DeConti

1973

Cancer

109

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Single agent chemotherapy employing either hydroxyurea, cyclophosphamide, bleomycin, or methotrexate has been reported to produce objective remissions in 30–40% of patients with advanced epidermoid carcinoma of the head and neck region. Responses are usually incomplete with remission durations of a few months. Methotrexate, the most extensively studied agent, appears to be most effective when used in an intermittent (every 4–7 day) dosage schedule or when used in high dosage followed by leucovorin “rescue.” In some reports, the intra‐arterial administration of these drugs achieved better response rates, but the value of this approach is diminished by the high frequency of lesions that extend beyond the infused arterial supply and the high complication rate of catheterization procedures. Initial studies with dichlo‐romethotrexate, an equipotent analog of methotrexate which is hydroxylated to an inactive form by the liver, suggest that intra‐arterial use of this unique compound may be of value. Several studies indicate that the use of drugs in combination with radiotherapy may achieve greater tumor regression and longer response durations than radiotherapy alone; however, more controlled studies will be needed to establish this. The availability of effective agents with diverse mechanisms of action strongly suggests that major gains in chemotherapy of these tumors will be made in the next decade using combinations of drugs.

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