Metronomic chemotherapy in advanced oral cancers

Context: To assess the feasibility of metronomic chemotherapy in the palliative care setting. Aims: To study the toxicity profile and efficacy of metronomic chemotherapy for palliation in oral cavity cancers. Settings and Design: Retrospective analysis of prospectively collected data. Materials and Methods: Subjects receiving metronomic chemotherapy from August 2010 to January 2011 for palliation in oral cancers subjected to certain criteria were included. Metronomic chemotherapy offered was a combination of twice daily celecoxib 200 mg and weekly methotrexate 15 mg/m (2) .The chemotherapy was continued till disease progression, intolerable side effects or patients desire to stop. The toxicity profile was reported in accordance with common terminology criteria for adverse events (CTCAE) version 4.02. The efficacy was noted in terms of symptom control, response rates, progression free survival (PFS) and overall survival (OS). Statistical analysis used: SPSS version 16 has been utilized. Descriptive analysis has been presented. The Kaplan-Meier survival analysis was performed for estimation of the PFS and OS. Results: Eighteen patients with a median age of 50.5 years, 13 males and 5 females, participated in the study. Five patients had received no previous treatment while the rest had some form of previous treatment. ECOG performance status was 1 in 14 patients and 2 in 4 patients. Grade 3-4 mucositis was seen in one patient. Clinical benefit rate was 66.67. The estimated median PFS and median OS were 5.2 months and not reached respectively. Conclusions: Use of metronomic chemotherapy seems promising and well tolerated in this setting. Large trials are warranted to confirm these results.