Impact of Oral Metronomic Therapy on Quality of Life in Advanced/Recurrent Head and Neck Squamous Cell Carcinoma Patients

ABSTRACT

Introduction: Metronomic chemotherapy (MC) is an emerging therapeutic option in clinical oncology and it may prove usefulat least in metastatic head and neck squamous cell carcinoma (HNSCC) patients. To develop rational therapeutic strategies,it is important to identify molecular targets that are linked to the pathogenesis of HNSCC.Aim: The aim of the study was to assess the effect of oral MC on changes in quality of life (QOL) in advanced/recurrent HNSCCpatients.Materials and Methods: Patients with advanced, metastatic, and recurrent HNSCC patients who are not amenable to localtreatment with surgery, radiotherapy, and chemotherapy were included in the study. QOL assessed with the European organizationfor research and treatment of cancer (EORTC) QLQ-C30 and QLQ-H&N 35 questionnaires.Results: In this study, 50 patients were included, 37 patients (74%) become pain-free at the end of 6 months. A decreasedpain grade was observed in another 13 patients (26%). Mean QLQ-C 30 score at the time of presentation was 68.67, 75.35at 2 months, 81.26 at 4 months, and 85.38 at the end of 6 months. Mean QLQ-H&N 35 score at the time of presentation was61.53, 72.16 at 2 months, 76.43 at 4 months, and 81.69 at the end of 6 months. In subgroup analysis, both QLQ-C30 andQLQ-H&N 35 significantly correlated with disease progression.Conclusion: The use of oral metronomic therapy with methotrexate and celecoxib significantly improves the QOL and improvespain control in patients with advanced/recurrent HNSCC