Effect of neoadjuvant single drug methotrexate therapy on tumor size reduction in oral squamous cell carcinoma: A pilot study

BackgroundThe aim of the study was to evaluate the response of Stage III, IV Oral Squamous Cell Carcinoma to Methotrexate as a single neoadjuvant treatment given Intramuscularly weekly, its utility in surgical management of Oral Squamous Cell Carcinoma and occurrence of adverse effects of Methotrexate.Methods20 Patients with stage III & IV, histopathologically proven oral squamous cell carcinoma were selected for Chemotherapy prior to definitive treatment. Methotrexate 1 mg/kg body weight was given intramuscularly once a week for 4 weeks along with hydration. After the reduction in tumor bulk patients were sent for definitive treatment.ResultsA study of 20 patients was done over a duration of 2 years. Clinically, the percentage reduction in tumor size after first, second, third and fourth dose of Methotrexate in anteroposterior direction was 20.16%, 5.61%, 4.08%, 8.13% respectively. In Buccolingual direction, the percentage reduction in size of the tumor after first, second, third and fourth dose was 13.75%, 5.51%, 6.63%, and 6.01% respectively. On USG, after 4 doses the % reduction in tumor size was 33.69% in length, 23.05% in breadth, and 12.55% in depth. p-value was found to be statistically significant.ConclusionsIt is a simple, cost effective regimen, requires minimal monitoring and can be administered on O.P.D. basis.