An alternative approach with a low dose and prolonged chemotherapy for palliative treatment of locally advanced, metastatic or recurrent squamous cell head and neck cancer

Abstract

Background: It is expected that about 65,000 new patients will be diagnosed with head and neck cancer in 2017 in the United States. Patients with recurrent or advanced or metastatic head and neck do not have good survival due to aggressive and recurrent nature of this cancer. Moreover, cumulative and residual toxicities from previous and ongoing treatments significantly impede quality of remaining part of their life. Currently available chemotherapeutic regimens for this group are derived from the treatments used for the potentially curable disease. These regimens and associated toxicity are obviously not the best matches for the treatment with palliative intent. We here present a retrospective study where we used dose-adjusted chemotherapy specifically for palliative treatment this sub-group of head and neck cancer patients.

Metronomic Chemotherapy in Oral Cancer: A Review

“…But, literature also shows that pembrolizumab, cetuximab, lapatinib, afatinib, and avelumab did not improve disease-free survival [1,6]. Several patients with advanced cancer would not pursue further chemotherapy unless their treatment has tolerable side effects with maintenance of the functional and psychological quality of life [19,20].…”

“…Conventional chemotherapy with a combination of two or three drugs is administered for four to six cycles but has to be restricted due to toxic side effects [20]. The functional and psychological quality of life should be maintained for cancer patients [19].…”

“…Several patients with advanced cancer would not pursue further chemotherapy unless their treatment has tolerable side effects with maintenance of the functional and psychological quality of life [ 19 , 20 ]. Conventional chemotherapy with a combination of two or three drugs is administered for four to six cycles but has to be restricted due to toxic side effects [ 20 ]. The functional and psychological quality of life should be maintained for cancer patients [ 19 ].…”

High-throughput metabolomics reveals dysregulation of hydrophobic metabolomes in cancer cell lines by Eleusine indica

“…Prolonging treatment time while reducing drug dose can be a useful way of potentially minimizing undesirable side effects. A similar approach was applied in a clinical study conducted by Bishnoi et al (2017) on recurrent, advanced, and metastatic cancer; lowering the chemotherapeutic dosage but prolonging therapy to achieve the desired outcomes extended patient survival while reducing undesirable side effects including nausea, neuropathy, fatigue, sepsis, and thrombocytopenia 38 . Similar results have been reported for advanced cancers, with improved quality of life achieved by application of this therapeutic approach 39 – 41 .…”