Oral uracil and tegafur as postoperative adjuvant metronomic chemotherapy in patients with advanced oral squamous cell carcinoma

Abstract

Background/purpose: In this study, we evaluated the effectiveness of oral uracil etegafur (UFUR) as a postoperative adjuvant treatment for patients with advanced oral squamous cell carcinoma (OSCC). Materials and methods: The study cohort consisted 80 patients with advance cancer treated between January 2003 and December 2007. Half of the patients received oral UFUR as postoperative metronomic adjuvant chemotherapy, while the other half received no treatment. No patients received postoperative radiotherapy or other systemic chemotherapy. Disease-free survival and toxicity were evaluated in these two groups. Twenty-two patients were assessed pre-and postoperatively for viable circulating endothelial progenitor cells using flow cytometry. Results: The disease-free survival rates at 4 years were 84.6% with oral UFUR treatment and 60.9% without UFUR therapy (P Z 0.02). The toxicity and disease progression profiles did not differ significantly between the two groups, but viable circulating endothelial progenitor cell counts decreased after the administration of oral UFUR. Advanced OSCC patients who received oral UFUR had a better prognosis than those who did not. Conclusion: Oral UFUR is a promising postoperative metronomic adjuvant chemotherapy regimen for advanced OSCC.Please cite this article in press as: Lin J-S, et al., Oral uracil and tegafur as postoperative adjuvant metronomic chemotherapy in patients with advanced oral squamous cell carcinoma, Journal of Dental Sciences (2015), http://dx.

Metronomic Therapy in Oral Squamous Cell Carcinoma

“…The results revealed that patients treated with metronomic UFUR had a significant reduction in the detectable viable CEP cells, which might implicate an antiangiogenesis mechanism behind the survival benefits. The toxicities were mild and manageable, with skin rash (5%) being the most common side-effect, followed by hematological side-effects (2.5%) and nausea/vomiting (2.5%) [103]. Hsieh et al [104] conducted a retrospective study of 356 stage III and IV OCSCC patients.…”

“…Although the enteral route for metronomic agents brings convenience and at-home treatment, it should be noted that some OCSCC patients have difficulty in swallowing. This issue matters and affects patient compliance if metronomic chemotherapy is used as adjuvant/maintenance therapy in OCSCC, which might last for 1-2 years [103,104].…”

The Effectiveness and Safety of Metronomic Chemotherapy in Patients with Head and Neck Carcinoma: A Systematic Review and Meta-analysis

“…One study set two groups including 75 mg/m² docetaxel every 21 days and 75 mg/m² docetaxel pulse 40mg AT-101 twice daily for 3 days, which was different in using of AT-101 compared with metronomic group [18]. And one study did not give other therapies after surgery which de ned as blank control [20].…”

“…Then 67 records including 9 comments or abstracts related to the aim of study were excluded. Finally, 13 records meeting criteria, including 3 randomized control trails [17][18][19], 1 cohort study [20], 4 prospective studied (3 single arm trials [21][22][23], 1 match pair analysis [24]) and 5 retrospective studies [25][26][27][28][29] were included.…”

“…In terms of tumor location, oral cavity occupied the most proportion, and next were pharynx and larynx. Most studies reported Eastern Cooperative Oncology Group performance status score of participants, except one study that used the Karnofsky Performance Status [19] and three studies did not report which standard they used [20,27,28]. Four studies reported their dropout or loss data [17,19,21,23], while remaining did not give the information.…”