Impact in Quality of Life with Gefitinib Plus Methotrexate Combination Metronomic Chemotherapy in Advanced and Metastatic Head and Neck Cancer - A Prospective Study from a Tertiary Cancer Centre, South India

International Journal of Medical Science

© 2023 by SSRG - IJMS Journal

Volume 10 Issue 4

Year of Publication : 2023

Authors : A. H. Rudresha, K. V. Kavi Sankar, Linu Abraham Jacob, M. C. Suresh Babu, K. N. Lokesh,L. K. Rajeev, Smitha Saldanha, Tarjina Begum

10.14445/23939117/IJMS-V10I4P107

How to Cite?

A. H. Rudresha, K. V. Kavi Sankar, Linu Abraham Jacob, M. C. Suresh Babu, K. N. Lokesh,L. K. Rajeev, Smitha Saldanha, Tarjina Begum, "Impact in Quality of Life with Gefitinib Plus Methotrexate Combination Metronomic Chemotherapy in Advanced and Metastatic Head and Neck Cancer - A Prospective Study from a Tertiary Cancer Centre, South India," SSRG International Journal of Medical Science, vol. 10,  no. 4, pp. 34-42, 2023. Crossref, https://doi.org/10.14445/23939117/IJMS-V10I4P107

Abstract:

Patients with advanced Squamous cell Carcinoma of the Head and Neck (SCCHN) have poor prognosis despite the available treatment options. QOL is an important end-point in evaluating treatment results in patients with advanced metastatic disease. This study looked into the impact of metronomic chemotherapy combining gefitinib and methotrexate on the quality of life in patients with advanced SCCHN. This was a single-center, prospective observational study conducted in our hospital over a period of 2 years (January 2021-December 2022). 131 patients with advanced or metastatic or recurrent head and neck squamous cell cancers who are not eligible for Platinum or 5 Fluorouracil-based IV chemotherapy due to poor performance status (or) already received palliative IV chemotherapy. It progressed in the same, and those who were unsuitable for loco-regional treatment were included in our study. They received Gefitinib 250mg daily plus methotrexate 15mg once a week orally on D1, D8, D15 and D22 of a 28-day cycle. Quality Of Life assessment before starting treatment and at 3 months and 6 months post-therapy was done with EORTC QLQC30 version 3.0 and EORTC QLQ-H&N35 questionnaires. Gefitinib, along with methotrexate, was well tolerated and was found to have a positive impact on the quality of life of patients with advanced SCCHN. The median improvement in quality of life was 42 points on a scale of 100. Head and neck cancer has severe effects on the quality of life. Assessing health-related quality of life should be an integral part of treatment planning and should be considered as important as treatment burden, toxicity, and survival benefit. Metronomic chemotherapy with gefitinib and methotrexate is associated with improvement in QOL and helps decrease the duration of time spent in the toxicity state.

Keywords:

Advanced recurrent metastatic head and neck squamous cell cancer, Oral metronomic chemotherapy, Palliative chemotherapy in head and neck squamous cell cancers, Supportive care in head and neck cancers.

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