title: Gefitinib, Methotrexate and Methotrexate plus 5-Fluorouracil as palliative treatment in recurrent head and neck squamous cell carcinoma.
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.
authors.affiliation: a Department of Radiotherapy ; King George's Medical University ; Lucknow , India.
authors.forename: Vandana Singh
authors.initials: VS
authors.lastname: Kushwaha
authors.forename: Seema
authors.initials: S
authors.lastname: Gupta
authors.forename: Nuzhat
authors.initials: N
authors.lastname: Husain
authors.forename: Huma
authors.initials: H
authors.lastname: Khan
authors.forename: M P S
authors.initials: MP
authors.lastname: Negi
authors.forename: Naseem
authors.initials: N
authors.lastname: Jamal
authors.forename: Ashim
authors.initials: A
authors.lastname: Ghatak
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D000077156:Gefitinib; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010166:Palliative Care; D011788:Quality of Life; D011799:Quinazolines / Q000008:administration & dosage; D000077195:Squamous Cell Carcinoma of Head and Neck; D016896:Treatment Outcome
chemical_list: D011799:Quinazolines; D000077156:Gefitinib; D005472:Fluorouracil; D008727:Methotrexate
keywords: ECOG, Eastern Cooperative Oncology Group; EGFR, Epidermal growth factor receptor; HNSCC, Head and neck squamous cell carcinoma; QOL, Quality of life; gefitinib; head and neck; methotrexate; recurrent; squamous cell carcinoma