Biomedical subjects
Publications and source records attributed to W B Fleming.
Forty four patients with squamous cell carcinoma of the head and neck from a variety of primary sites were treated with high dose methotrexate with folinic acid rescue from 1975 to 1977. The overall response rate was 66%. Response duration was short with a mean of 16 weeks. The usefulness of this technique in the treatment of head and neck cancer is discussed.
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Until chemotherapy is proved more effective in the initial management of squamous cell cancer of the mouth and throat, radiation and surgery will remain the principal treatment modalities. This paper documents a treatment selection process which is used in the Head and Neck Clinic of the Peter MacCallum Hospital. Anatomical resectability, potential of control by radiation, disability and deformity produced by surgery, presence of metastases, psychological factors, and concurrent disease, as well as tumour behaviour, are all factors which influence the choice of radiation or surgery, alone, or in combination, in the treatment of each patient.
The five year results of excision of cancer of the oral cavity and oropharynx in 172 patients selected for surgical treatment are reported. The overall survival rate was 48.8%, with 39.5% of patients dying with persistent or recurrent disease. An unexpectedly high survival rate of 42.2% was achieved in 45 patients with residual or recurrent tumour resected after failed initial radiation therapy.