NUMERO: #20250349

Título: BEYOND SURGERY AND SYSTEMIC THERAPY: INTRA-ARTERIAL METHOTREXATE IN A CHALLENGING ORAL CANCER CASE

Nome do Apresentador: Anna Luiza Damaceno ARAUJO

Categoria do Trabalho: Painel de caso clínico (PCC)

Área Temática: Odontologia hospitalar

Resumo: A 48-year-old male with a history of moderately differentiated keratinizing squamous cell carcinoma (pT1pN1), initially treated with partial maxillectomy, lymphadenectomy, radiotherapy, and concurrent cisplatin in mid-2023, presented with locoregional recurrence. Despite multiple systemic therapies-including carboplatin, 5-FU, pembrolizumab, docetaxel, and cetuximab-disease progression persisted. Surgery was not feasible due to high morbidity and recent radiotherapy. Given the absence of distant metastasis, intra-arterial methotrexate (MTX, 25 mg every 12h for 7 days) was initiated via a superficial temporal artery port, combined with leucovorin rescue (15 mg IV every 6h). During treatment, the patient developed facial edema, subfebrile temperatures, and increased secretions, with no infectious source. Supportive care included oral hygiene, hydration, and thromboembolism prophylaxis. MTX was chosen to achieve local tumor control with reduced systemic toxicity, considering the poor response to prior regimens and high PD-L1 CPS score.

Autor 1:  Anna Luiza Damaceno ARAUJO

E-mail 1:  [email protected]

Autor 2:   Jessica dos Santos RODRIGUES

E-mail 2:  [email protected]

Autor 3 :  Aline Pereira de MENEZES

E-mail 3:  [email protected]

Autor 4:  Mariana Henriques FERREIRA

E-mail 4:  [email protected]

Autor 5:  Fernanda de Paula EDUARDO

E-mail 5:  [email protected]

Autor 6:  Juliana Mota SIQUEIRA

E-mail 6:  [email protected]

Autor 7:  Letícia Mello BEZINELLI

E-mail 7:  [email protected]