METRONOMIC CHEMOTHERAPY IN RECURRENT, RESIDUAL AND METASTATIC HEAD & NECK CANCERS

SHILPA KANDIPALLI; T. KANNAN; Bhargavi D; RAVI SANKAR. A; PRAVEENA VOONNA; V. SANTOSH

Volume : VIII, Issue : VI, June - 2018

METRONOMIC CHEMOTHERAPY IN RECURRENT, RESIDUAL AND METASTATIC HEAD & NECK CANCERS

Shilpa Kandipalli, T. Kannan, Bhargavi D, Ravi Sankar. A, Praveena Voonna, V. Santosh

Abstract :

Background: Despite advances in multimodality therapy, options for patients with Recurrent Head&Neck cancers are desparately limited. Hence, the present study was done to evaluate the role of Metronomic Chemotherapy in Recurrent, Residual and Metastatic Head & Neck cancers with regard to Response and Progression Free Survival.

Methods: Oral Metronomic Chemotherapy with Methotrexate and Capecitabine was given to all patients who met the inclusion criteria in our study. Response assessment was done at end of 3 months and 6 months and compared to baseline imaging using RECIST 1.1 criteria. Toxicities and Progression Free Survival were also analysed.

Results: At 6 months follow up, Stable disease was observed in 34%, Partial response in 19.1% with an overall response rate of 53.1%. Progressive disease was seen in 40.4%, initial stable disease followed by progressive disease in 6.4% of the patients. Toxicities were minimal. The Overall Mean progression free survival (PFS) was 164 days (5.5months) + 36days (95% confidence interval)

Conclusion: Oral Metronomic Chemotherapy with Capecitabine and Methotrexate is a good alternative to conventional intravenous chemotherapy in patients with Recurrent, Residual and Metastatic Head & Neck cancers with good response rates, better toxicity profile andsignificant improvement in PFS especially in patients with good PS