Influence of stage classification, tumor differentiation and mode of invasion against clinical and histopathological effects on low dose sequential methotrexate and 5-fluorouracil administration as neo-adjuvant chemotherapy for oral squamous cell carcinoma.
We report on the influences of stage classification, tumor differentiation and mode of invasion against clinical and histopathological effects associated with low dose sequential methotrexate (MTX) and 5-fluorouracil (5-FU) (MF therapy) as neo-adjuvant chemotherapy in oral cancer. The oral cancer of 22 patients was treated as follows: MTX (75 mg/body) was administrated by intravenous infusion for 1 hour, followed by 5-FU (500 mg/body) intravenous infusion for 2 hours on Day 1, MTX (75 mg/body) intravenous infusion for 1 hour on Day 4, and parenteral dose of leucovorin on Day 2 and Day 5. The MF therapy of 1-5 courses was performed weekly or every 2 weeks. The clinical response rate was lower in stage IV than in the other stages. There was no difference in the rate of tumor differentiation by WHO grade classification, I and II. The rate was higher in grade 1, 2 and 3 than in grade 4C and 4D due to mode of invasion. The histological response rate was higher in stage I and II than in stage III and IV. The response rate was higher in grade II than in grade I, but was higher in grade 1 and 2 than in grade 3 and 4C. However, the response rate in grade 4D was good (66.7%; 2/3). Histological response was demonstrated only in partial or complete response cases of the clinical response. MF therapy was suggested to be effective for histological response regardless of stage classification, tumor differentiation and mode of invasion, although its success rate was low in stage III, IV (stage classification), grade I (tumor differentiation), grade 3 and 4C (mode of invasion).
Asaumi
J
J
Department of Dentistry and Oral Surgery, National Okayama Hospital, Okayama City, Japan.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology; D002454:Cell Differentiation; D004334:Drug Administration Schedule; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage*; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000188:drug therapy* / Q000473:pathology; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging
D000964:Antimetabolites, Antineoplastic; D005472:Fluorouracil; D008727:Methotrexate