Gefitinib,Methotrexate and Methotrexate plus 5-Fluorouracil as palliative treatment in recurrent head and neck squamous cell carcinoma |
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Authors: | Vandana Singh Kushwaha Seema Gupta Nuzhat Husain Huma Khan MPS Negi Naseem Jamal Ashim Ghatak |
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Affiliation: | 1.Department of Radiotherapy; King George''s Medical University; Lucknow, India;2.Department of Pathology; Ram Manohar Lohia Institute of Medical Sciences; Lucknow, India;3.Clinical and Experimental Medicine Division; CSIR-Central Drug Research Institute; Lucknow, Uttar Pradesh, India |
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Abstract: | This study compared the efficacy and toxicity of Gefitinib, Methotrexate and Methotrexate plus 5-Fluorouracil (5-FU) in patients of recurrent squamous cell carcinoma of head and neck (SCCHN) treated with palliative intent. Patients with recurrent SCCHN not amenable to curative treatment were randomly assigned to Gefitinib, Methotrexate or Methotrexate plus 5-FU arm. The primary end point was overall survival. Secondary end points of interest were objective response rate, toxicity and quality of life. Total 117 patients were analyzed. Median overall survival and objective response rates were 8.8 months, 7.8 months and 8.1 months and 7.7%, 5.0% and 7.9% in Gefitinib, Methotrexate and Methotrexate plus 5-FU arms respectively with no statistically significant difference between 3 arms. Gefitinib had different toxicity profile compared with other arms. Majority of toxicities were Grade 1 or Grade 2. Gefitinib had significant improvement in quality of life during initial months over Methotrexate. There was no suggestion that Gefitinib significantly prolonged overall survival compared with Methotrexate and Methotrexate plus 5-FU. However, improved Quality of Life with manageable toxicities was observed. |
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Keywords: | gefitinib head and neck methotrexate recurrent squamous cell carcinoma |
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