title: Palliative low dose fortnightly methotrexate in oral cancers: Experience at a rural cancer centre from India.
abstract: BACKGROUND
  Palliative fortnightly chemotherapy in oral cancers.
  
  
  OBJECTIVE
  We present our experience with a regimen employing fortnightly (once in 2 weeks) injectable methotrexate (MTX) (40 mg/m(2) ) in a predominantly elderly cohort of patients with carcinoma of oral cavity and oropharynx.
  
  
  METHODS
  Retrospective chart review conducted at a rural cancer center in India.
  
  
  METHODS
  All patients with oral cavity and oropharyngeal cancers started on treatment with fortnightly injectable MTX (40 mg/m(2) ) between 01/01/2011 and 31/12/2011.
  
  
  METHODS
  The factors analyzed included the duration of disease control, pain control, overall survival and progression free survival which were evaluated using the Kaplan Meier method.
  
  
  RESULTS
  A total of 60 patients with a median age of 66.5 years were analyzed. Majority of the patients had poor nutritional status, performance status or co-morbidities. MTX was given for recurrent disease in 19 patients and after initial palliative radiotherapy in 41 patients. The median number of cycles delivered was nine. Grade 3/4 toxicities were seen in 2 patients only. Disease control rate at the end of treatment was seen in 33 (55%) patients. Median overall survival was 34 weeks (interquartile range: 17-50 weeks).
  
  
  CONCLUSIONS
  The fortnightly regimen of MTX was well-tolerated and showed a good clinical activity in this elderly cohort of patients with advanced oral cavity and oropharyngeal cancers.
authors.affiliation: Department of Radiation Oncology, Malabar Cancer Centre, Thalassery, Kerala, India.
authors.forename: Santam
authors.initials: S
authors.lastname: Chakraborty
authors.affiliation: Department of Cancer Palliative Medicine, Malabar Cancer Centre, Thalassery, Kerala, India.
authors.forename: M
authors.initials: M
authors.lastname: Geetha
authors.affiliation: Department of Surgical Oncology, Malabar Cancer Centre, Thalassery, Kerala, India.
authors.forename: K M
authors.initials: KM
authors.lastname: Sujith
authors.affiliation: Department of Cancer Palliative Medicine, Malabar Cancer Centre, Thalassery, Kerala, India.
authors.forename: M S
authors.initials: MS
authors.lastname: Biji
authors.affiliation: Department of Surgical Oncology, Malabar Cancer Centre, Thalassery, Kerala, India.
authors.forename: B
authors.initials: B
authors.lastname: Sateeshan
keywords: Methotrexate; oral cancer; palliative chemotherapy; squamous cell cancers