levoleucovorin and Mouth-Neoplasms

Topics: Bleomycin; Carcinoma, Squamous Cell; Drug Administration Schedule; Drug Therapy, Combination; Fluorouracil; Head and Neck Neoplasms; Humans; Hydroxyurea; Laryngeal Neoplasms; Leucovorin; Lip Neoplasms; Lymphatic Metastasis; Methotrexate; Mouth Neoplasms; Nasopharyngeal Neoplasms; Tongue Neoplasms

Topics: Adult; Aged; Antineoplastic Agents; Bleomycin; Carcinoma, Squamous Cell; Cisplatin; Clinical Trials as Topic; Drug Administration Schedule; Drug Therapy, Combination; Female; Head and Neck Neoplasms; Humans; Laryngeal Neoplasms; Leucovorin; Male; Methotrexate; Middle Aged; Mouth Neoplasms; Pharyngeal Neoplasms

Since January 1974, 95 patients with anterior tongue and floor of the mouth cancers were included in a randomized trial. After stratification according to staging and initial treatment, one-third of the patients received chemotherapy for 2 years (methotrexate 400 mg followed by citrovorum factor 100 mg + bleomycin 60 mg/week, during the first 15 weeks), one-third of the patients received immunotherapy with weekly C. parvum injections during 2 years, while the remaining third did not receive any treatment. If adjuvant treatment seems to delay recurrence it did not significantly decrease the recurrence rate. Survival is also not signigicantly modified by adjuvant treatment and was better for patients with small tumors. Patients who previously received radiotherapy did not benefit from adjuvant therapy.

Topics: Antigens, Bacterial; Bleomycin; Carcinoma, Squamous Cell; Drug Therapy, Combination; Humans; Leucovorin; Methotrexate; Mouth Floor; Mouth Neoplasms; Neoplasm Metastasis; Neoplasm Recurrence, Local; Propionibacterium acnes; Random Allocation; Tongue Neoplasms

Topics: Adult; Aged; Carcinoma, Squamous Cell; Clinical Trials as Topic; Female; Head and Neck Neoplasms; Humans; Leucovorin; Male; Methotrexate; Middle Aged; Mouth Neoplasms

Topics: Chemotherapy, Adjuvant; Humans; Leucovorin; Mouth Neoplasms; Tegafur

The relationship between the volumetric and histologic responses of metastatic cervical nodes to radiotherapy or chemotherapy in the oral and maxillofacial region is unclear. In this study, we evaluated the correlation between the initial volume and regression rate of metastatic nodes with their histologic response to preoperative radiotherapy or radiochemotherapy.. The volume of 54 metastatic nodes in 32 patients with squamous cell carcinoma in the oral and maxillofacial region was measured by ultrasonography before and after preoperative therapy, and the rate of the volume change was calculated. All surgically removed nodes were histologically classified as poor, good, or complete response according to their histologic features.. There was no significant difference in initial volume among the 3 response groups. Good and complete response nodes showed a significant increase in regression rate compared with poor response nodes. All 11 nodes showing no regression were poor response nodes, and 7 with a regression rate of more than 90% were good or complete response nodes. The remaining 36 nodes (regression rate, 0% to 90%) represented all 3 types of histologic response. Of these, 7 of 9 complete response nodes were found in 5 patients who received combination chemotherapy consisting of 5-fluorouracil, leucovorin, and cisplatin.. The initial nodal volume before therapy is not a good indicator for the response to radiotherapy and/or chemotherapy. A regression rate of more than 90% may be a useful predictor of the effectiveness of preoperative treatments, but it was difficult to define the cutoff values in regression rates for differentiating types of histologic response.

Topics: Adult; Aged; Aged, 80 and over; Antimetabolites, Antineoplastic; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Squamous Cell; Cisplatin; Female; Fluorouracil; Humans; Leucovorin; Lymph Node Excision; Lymph Nodes; Lymphatic Metastasis; Male; Middle Aged; Mouth Neoplasms; Neck; Neoadjuvant Therapy; Remission Induction; Statistics, Nonparametric

To evaluate the feasibility and effectiveness of a concurrent radio-chemotherapy regimen for locally advanced carcinomas of the pharynx and floor of the mouth.. Since January 1990, 97 patients with locally advanced carcinomas of the naso-, oro-, hypopharynx and the oral cavity in UICC stages III and IV were treated according to an accelerated hyperfractionated radiotherapy schedule with concurrent chemotherapy. The primary tumor and positive lymph nodes received a total dose of 72 Gy in 6 weeks. In the first 3 weeks, large fields were irradiated 5 times per week with 2 Gy per fraction. Thereafter, treatment was accelerated, giving 2 daily fractions of 1.4 Gy with minimal intervals of 6 hours. Target volumes were reduced after 49.6 and 59.4 Gy, excluding clinically uninvolved lymph node regions of low and high risk. On day 1, 350 mg/m2 5-FU and 50 mg/m2 folinic acid were given as intravenous bolus followed by continuous infusion of 350 mg/m2 5-FU and 100 mg/m2 folinic acid, days 1 to 5. 10 mg/m2 mitomycin C was given on day 5 and 36 of the treatment. Salvage surgery was offered for residual disease 5 to 6 weeks after the end of radiotherapy.. 70 male, 27 female; age: 27 to 81 years; T2/T3/T4: 7/30/60; N0/N1/N2/N3: 20/18/53/6; nasopharynx/oropharynx/hypopharynx/oral cavity: 16/33/36/12. Median follow-up is 26 months.. Overall survival and recurrence-free survival at 2 years were. Overall survival and recurrence-free survival at 2 years were 68 +/- 5% and 74 +/- 5%. Multivariate analysis revealed a significant influence of the geometric mean neck node diameter or the N-stage on loco-regional control and survival. T-stage, tumor volume, or tumor localisation did not become significant. Acute toxicity of this schedule was acceptable but required optimised supportive care. Treatment related grade 4+ late toxicity of mucosa, soft tissue and bone were observed with a cumulative frequency of 13% at 2 years. Two patients died during a phase of severe leuko- or thrombocytopenia.. This phase I to II trial shows favourable results using an intensified treatment radio-chemotherapy protocol. A phase III study is now planned, comparing this regime with an accelerated hyperfractionated radio-therapy alone to an increased total dose of 77.6 Gy.

Topics: Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Squamous Cell; Combined Modality Therapy; Female; Fluorouracil; Humans; Leucovorin; Male; Middle Aged; Mitomycin; Mouth Neoplasms; Neoplasm Staging; Particle Accelerators; Pharyngeal Neoplasms; Pilot Projects; Radiotherapy Dosage

A case of severe oral ulceration, following administration of combination chemotherapy which included methotrexate, is reported. Topically applied folinic acid was effective in facilitating resolution of the oral lesions.

Topics: Administration, Topical; Carcinoma, Squamous Cell; Humans; Leucovorin; Male; Methotrexate; Middle Aged; Mouth Diseases; Mouth Neoplasms; Ulcer

Topics: Drug Therapy, Combination; Fluorouracil; Humans; Leucovorin; Methotrexate; Mouth Neoplasms

Although experience with drug therapy of advanced or recurrent squamous cell carcinoma of the head and neck is limited, several agents have produced convincing and reproducible tumor regression in these patients. Methotrexate has had the widest usage, and produces 30-50% response rates; bleomycin, hydroxyurea, and adriamycin appear to be somewhat less effective. Location of the malignancy and previous x-ray treatment appear to be important determinants of responsiveness to methotrexate, while degree of differentiation has not yet been shown to be an important factor for response to this drug. Attempts to improve the response rate and duration of chemotherapeutic response by utilizing combinations of drugs, or use of drugs to sensitize the tumor to x-ray treatment, or to reduce the bulk of tumor before x-ray treatment, are reviewed; they have been only moderately encouraging. Intra-arterial chemotherapy appears to have a therapeutic advantage over intravenous treatment; however, the morbidity associated with the former approach limits its usefulness for routine usage. The use of drugs as adjuncts following surgery and/or radiation therapy or immunotherapy are newer approaches that have not been investigated sufficiently, but are promising areas for investigation.

Topics: Bleomycin; Dinitrochlorobenzene; Doxorubicin; Drug Therapy, Combination; Fluorouracil; Head and Neck Neoplasms; Humans; Immunotherapy; Infusions, Parenteral; Injections, Intra-Arterial; Leucovorin; Methotrexate; Mouth Neoplasms; Recurrence

The inadequacies of traditional methods for control of advanced oral carcinomas at their sites of origin prompted evaluation of combined chemotherapy and cryosurgery in seventy-three patients treated since 1969. Our experience with thirty-nine unlikely candidates for salvage by other therapy is the subject of this report. The majority had recurrent disease after other therapy. The observed morbidity potential of combined chemotherapy and cryosurgery with earlier experience led to abbreviations and refinements of method that are described and consist mainly of the following. (1) A two day postcryosurgical infusion (intra-arterial) of 5-fluorouracil (1 gm per twenty-four hours, or less) in lieu of methotrexate, the systemic toxicity and therapeutic efficacy of which seem less predictable with cryosurgery. (2) Electrosurgical subtotal tumor resection at the time of initial cryosurgery to reduce swelling and magnitude of in situ tissue slough. (3) Use of a flexible copper mesh cryoprobe that enhances feasibility of in-depth wide field cryosurgery. (4) Systematic use of multiple marginal wound biopsies as a principal guide to repetitive cryosurgery or other therapeutic adjunct selection. A special warning that available toxicologic data for independent drug therapy may not be applicable in patients after cryosurgery is given. Current experience indicates that negative biopsy after such combined therapy may be 85 per cent reliable in foretelling lesion outcome. Among the thirty-nine patients reported, twenty remain alive from six months to six years, only two of whom have clinically evident recurrent disease. If such could be reasonably accomplished, comparative evaluation of single methods should precede attempts to combine two or more modes of therapy. Since neither chemotherapy nor cryosurgery, as known today, can eliminate nodal metastases, each must be regarded as potentially adjunctive to other methods for achieving the ultimate goal of a cancer-free patient. It is within this context that combined chemotherapy and cryosurgery have been applied to unfavorable candidates for cure with seemingly worthwhile gains. Potential applicability for patients with less formidable stages of disease cannot be extrapolated from this experience. Large scale controlled clinical trials must provide the ultimately conclusive test of efficacy for such combined forms of therapy before decisive revision of traditional standards of practice might result.

Topics: Adult; Aged; Antineoplastic Agents; Carcinoma, Squamous Cell; Cryosurgery; Drug Therapy, Combination; Fluorouracil; Humans; Leucovorin; Male; Methods; Methotrexate; Middle Aged; Mouth Neoplasms; Neoplasm Recurrence, Local; Ohio; Tongue Neoplasms

Topics: Antibiotics, Antineoplastic; Antineoplastic Agents; Bleomycin; Carcinoma, Squamous Cell; Catheterization; Cyclophosphamide; Glutamates; Head and Neck Neoplasms; Humans; Hydroxyurea; Infusions, Parenteral; Injections, Intravenous; Leucovorin; Methotrexate; Mouth Neoplasms; Pteridines; Remission, Spontaneous

Topics: Adult; Aged; Carotid Artery, External; Catheterization; Evaluation Studies as Topic; Floxuridine; Fluorouracil; Gingival Neoplasms; Humans; Injections, Intra-Arterial; Leucovorin; Lip Neoplasms; Methotrexate; Middle Aged; Mouth Neoplasms; Palatal Neoplasms; Palliative Care

Topics: Adult; Aged; Anemia; Carcinoma, Squamous Cell; Cell Division; Drug Eruptions; Drug Synergism; Facial Neoplasms; Female; Head and Neck Neoplasms; Humans; Laryngeal Neoplasms; Leucovorin; Leukopenia; Lip Neoplasms; Male; Methotrexate; Middle Aged; Mouth Neoplasms; Mucous Membrane; Palatal Neoplasms; Pharyngeal Neoplasms; Tongue Neoplasms

Topics: Adenocarcinoma; Administration, Oral; Aged; Carcinoma, Adenoid Cystic; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Cystadenoma; Ear Neoplasms; Female; Head; Head and Neck Neoplasms; HeLa Cells; Humans; Leucovorin; Lymphoma, Large B-Cell, Diffuse; Male; Methotrexate; Middle Aged; Mouth Neoplasms; Osteosarcoma

Topics: Adenocarcinoma, Mucinous; Adult; Aged; Carcinoma, Squamous Cell; Female; Head and Neck Neoplasms; Humans; Infusions, Parenteral; Jaw Neoplasms; Laryngeal Neoplasms; Leucovorin; Leukopenia; Male; Methotrexate; Middle Aged; Mouth Neoplasms; Neoplasm Metastasis; Neoplasms; Paranasal Sinus Neoplasms; Pharyngeal Neoplasms; Salivary Glands; Thrombocytopenia; Tongue Neoplasms; Tonsillar Neoplasms

Topics: Antineoplastic Agents; Carcinoma; Chemotherapy, Cancer, Regional Perfusion; Fluorouracil; Head; Head and Neck Neoplasms; Humans; Leucovorin; Melanoma; Melphalan; Methotrexate; Mouth Neoplasms; Nasopharyngeal Neoplasms; Paranasal Sinus Neoplasms; Sarcoma; Thiotepa; Vinblastine

Topics: Adenocarcinoma; Blood Cell Count; Blood Chemical Analysis; Bone Marrow Examination; Carcinoma; Carcinoma, Papillary; Carcinoma, Squamous Cell; Drug Therapy; Facial Neoplasms; Hematopoiesis; Hemoglobinometry; Infusions, Intra-Arterial; Injections, Intra-Arterial; Injections, Intramuscular; Intestinal Neoplasms; Leucovorin; Methotrexate; Mouth Neoplasms; Myxosarcoma; Toxicology; Urine; Urogenital Neoplasms

Topics: Antimetabolites; Antineoplastic Agents; Bone Marrow; Carcinoma, Bronchogenic; Humans; Infusions, Intra-Arterial; Injections, Intra-Arterial; Leucovorin; Lung Neoplasms; Lymphatic Metastasis; Mouth Neoplasms; Neoplasms; Pelvic Neoplasms; Radiography; Tongue Neoplasms; Tonsillar Neoplasms

Topics: Head; Head and Neck Neoplasms; Humans; Leucovorin; Methotrexate; Mouth Neoplasms; Neoplasms