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Low Cost, Low Dose, Oral, Neoadjuvant Chemotherapy Protocol in Locally Advanced Borderline Oral Cancers—Feasibility Study

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Abstract

A vast majority of oral cancer patients in developing countries present in an advanced stage with borderline resectable/inoperable stage to busy resource-constrained tertiary cancer centers. Conventional chemotherapy protocols are associated with issues like toxicity, tolerance, cost, and compliance. The present study was conducted to assess the feasibility of low-cost home-based chemotherapy options. Single-arm feasibility study was done in borderline resectable/inoperable oral cancer patients. Home-based oral neoadjuvant chemotherapy consisting of oral methotrexate 15 mg/m2 once a week and oral celecoxib 200 mg twice daily for 8 weeks was used. RECIST Criteria 1.1 was used to assess response to therapy. The study included 60 patients. The mean age was 51.98 years with male predominance (80%). Fifty-five patients adhered to the treatment; the compliance rate is 91.60%. Affordability (Rs 700 per month) and tolerance to therapy was 100%, and no grade III or IV toxicity was seen. Overall, 18 patients had stable disease (32.73%), partial response was seen in 15 patients (27.27%), and the disease progressed in 22 patients (40%). At the end of 8 weeks, 26 (43.3%) patients were deemed resectable. Neoadjuvant low cost, home-based metronomic chemotherapy using oral methotrexate and celecoxib seems to be a viable option in managing advanced oral cancer in resource-constrained setups.

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Authors and Affiliations

  1. Department of Surgical Oncology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, 751003, India

    Mahesh Sultania

  2. Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, India

    S. V. S. Deo & N. K. Shukla

  3. Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India

    Atul Sharma & R. Sahoo

  4. Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India

    S. Bhasker

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  1. Mahesh Sultania
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  2. S. V. S. Deo
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  3. N. K. Shukla
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  4. Atul Sharma
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  5. R. Sahoo
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  6. S. Bhasker
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Correspondence to Mahesh Sultania.

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Sultania, M., Deo, S.V.S., Shukla, N.K. et al. Low Cost, Low Dose, Oral, Neoadjuvant Chemotherapy Protocol in Locally Advanced Borderline Oral Cancers—Feasibility Study. Indian J Surg Oncol 12, 67–72 (2021). https://doi.org/10.1007/s13193-020-01247-8

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  • DOI: https://doi.org/10.1007/s13193-020-01247-8

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