ABSTRACT
CONTEXT: Palliative fortnightly chemotherapy in oral cancers. AIMS: 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. SETTINGS AND DESIGN: Retrospective chart review conducted at a rural cancer center in India. MATERIALS AND 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. STATISTICAL ANALYSIS USED: 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.
ABSTRACT
Sarcomatoid carcinomas are biphasic tumors, which can occur at any site in the human body. Very few cases have been reported in the literature as arising from the penis. A few studies consider these tumors as a variant of squamous cell carcinoma or a metaplastic differentiation of the mesenchyme. Their clinical behavior is aggressive with both blood borne and lymphatic metastases. Treatment is by surgical excision, and dissected lymph nodes have shown both epithelial and sarcomatous components. We report a 50-year-old gentleman, with a sarcomatoid carcinoma of the penis, which was confirmed immunopathologically. The rarity of this entity makes it a clinicopathologic curiosity.
