Large intravenous dose of methotrexate and radiotherapy in the treatment of advanced oral cancers

Abstract

The incidence of oral carcinomas in Siriraj Hospital is the most common, forming about 12 per cent of all malignancies. The treatments for individual oral carcinoma adopted here are surgery, radiation and chemotherapy or a combination of these methods. In advanced cancers i.e. T3, T4 which are suitable for irradiation, after a full dose of radiation, from past experience, complete resolution of the tumour masses were rarely obtained. Surviving anoxic of hypoxic tumour cells still persisted in the tumour core. In such a patient, if post irradiation resection could not be performed, no further specific treatment could then be given. Within a short period of time, these residual tumours began to progress and the result was very frustrating. Many attempts have been made to enhance this dismal cure rate by combining radiation with other therapeutic modalities. The present study was designed to provide information about the therapeutic result and toxic effects of large intravenous doses of methotrexate before irradiation in the treatment of oral cancers.