Kirkwood J M, Miller D, Weichselbaum R, Pitman S W
Laryngoscope. 1979 Apr;89(4):573-81. doi: 10.1288/00005537-197904000-00006.
Advanced squamous carcinoma of the head and neck remains refractory to the best combinations of surgery and radiotherapy. Weekly methotrexate in high doses with leucovorin "rescue" is able to produce significant remissions in a majority of patients treated palliatively for recurrent disease yet is associated with little or no toxicity. We have attempted to improve the cure of patients with advanced disease by the use of high dose methotrexate (3-7.5 g/M2) and leucovorin prior to and following definitive surgery and/or radiotherapy. In a series of 24 patients we have achieved a response rate of 52%, with minimal toxicity during chemotherapy, and no apparent potentiation of toxicity with radiotherapy. Survival free of disease appears to be prolonged in patients with response to this chemotherapy. Multimodality approaches to locally advanced squamous carcinoma of the head and neck may soon yield improved cure rates.
头颈部晚期鳞状细胞癌对手术和放疗的最佳联合治疗仍具难治性。大剂量甲氨蝶呤每周给药并辅以亚叶酸“解救”，能够使大多数接受姑息性治疗的复发性疾病患者实现显著缓解，且几乎没有毒性或毒性极小。我们尝试通过在确定性手术和/或放疗之前及之后使用大剂量甲氨蝶呤（3 - 7.5 g/M²）和亚叶酸来提高晚期疾病患者的治愈率。在一组24例患者中，我们实现了52%的缓解率，化疗期间毒性极小，且放疗未明显增强毒性。对这种化疗有反应的患者无病生存期似乎得以延长。对头颈部局部晚期鳞状细胞癌的多模式治疗方法可能很快会提高治愈率。
