Effect of oral metronomic chemotherapy on quality of life in advanced or metastatic head and neck cancers

Manish Kumar Sharma; B. Ramkumar; G. Raja; Atul J. G.; Shaoni Parai; N. Vasanth Rooban

doi:10.18203/2320-6012.ijrms20242605

Authors

Manish Kumar Sharma Department of Medical Oncology, Government Royapettah Hospital (Kilpauk Medical College) Chennai, Tamil Nadu, India
B. Ramkumar Department of Medical Oncology, Government Royapettah Hospital (Kilpauk Medical College) Chennai, Tamil Nadu, India
G. Raja Department of Medical Oncology, Government Royapettah Hospital (Kilpauk Medical College) Chennai, Tamil Nadu, India
Atul J. G. Department of Medical Oncology, Government Royapettah Hospital (Kilpauk Medical College) Chennai, Tamil Nadu, India
Shaoni Parai Department of Medical Oncology, Government Royapettah Hospital (Kilpauk Medical College) Chennai, Tamil Nadu, India
N. Vasanth Rooban Department of Medical Oncology, Government Royapettah Hospital (Kilpauk Medical College) Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20242605

Keywords:

Quality of life, Chemotherapy, Metronomic chemotherapy, Head neck cancer

Abstract

Background: Oral Metronomic chemotherapy (OMCT) is an emerging therapeutic option in advanced/metastatic, head and neck squamous cell carcinoma (HNSCC). It is ideal for frail patients not candidates for platinum-based chemotherapy, and who have minimal response with progressive worsening of quality of life (QOL). To assess the effect of OMCT on changes in quality of life (QOL) in advanced/recurrent HNSCC patients.

Methods: Patients with advanced/metastatic recurrent HNSCC, not amenable to radical therapy were included in the study. QOL was assessed with the European organization for research and treatment of cancer (EORTC) QLQ-C30 and QLQ-H&N 35 questionnaires at enrollment and at regular follow up intervals after starting MC.

Results: Out of 54 patients, 50 % patients had grade 3 or more pain at enrolment, which improved after OMCT with only 5 % having grade 3 or more pain at 6 months. Mean QLQ-C 30 score at the time of presentation was 68.4. With oral MC, there was a steady increase in QOL score QLQ-C30; 75.35 at 2 months, 81.26 at 4 months, and 85.38 at the end of 6 months. Mean QLQ-H and N 35 score at the time of presentation was 62.50, which gradually improved with oral MC; 71.16 at 2 months, 75.43 at 4 months, and 80.69 at the end of 6 months.

Conclusions: The use of oral metronomic therapy with methotrexate, gefitinib and celecoxib significantly improved the QOL and pain control in patients with advanced/recurrent HNSCC.

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