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CC BY-NC-ND 4.0 · South Asian J Cancer 2022; 11(02): 146-151
DOI: 10.1055/s-0041-1735592
Original Article
Head and Neck Cancer

The Spectrum of Histomorphological Changes and Pathological Tumor Response following Preoperative Oral Metronomic Chemotherapy in Oral Squamous Cell Carcinoma

Sithara Aravind
1   Division of Oncopathology, Malabar Cancer Centre, Thalassery, Kerala, India
,
Jasmin Jose
1   Division of Oncopathology, Malabar Cancer Centre, Thalassery, Kerala, India
,
Praveen Kumar Shenoy
2   Division of Medical Oncology, Malabar Cancer Centre, Thalassery, Kerala, India
,
Manuprasad Avaronnan
2   Division of Medical Oncology, Malabar Cancer Centre, Thalassery, Kerala, India
,
Sajith Babu Thavarool
3   Division of Surgical Oncology, Malabar Cancer Centre, Thalassery, Kerala, India
,
Sangeetha K. Nayanar
1   Division of Oncopathology, Malabar Cancer Centre, Thalassery, Kerala, India
› Author Affiliations Funding None.
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Abstract

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Sithara Aravind

Background Oral metronomic chemotherapy (OMCT) represents an emerging concept in cancer treatment involving frequent administration of chemotherapeutic drugs at doses below maximum tolerated doses and with no prolonged drug-free break. OMCT is being tried preoperatively in developing nations with constrained resources to prevent disease progression during the waiting period from diagnosis to surgery (bridge OMCT). The aim of the present study was to assess the spectrum of histomorphological changes and pathological tumor response following bridge OMCT in oral squamous cell carcinoma (OSCC) and to propose a new pathological response scoring system.

Materials and Methods A retrospective single-center study comprised of tissue sections of tumor proper and metastatic lymph nodes of 50, locally advanced OSCC patients treated with bridge OMCT, and had completed definitive surgery were analyzed. The present study evaluated the histomorphological features and proposed a new scoring system for pathologic tumor response. The pathologic tumor response was categorized as complete response (pCR), no response (pNR), and partial response (pPR).

Results Of the total 50 patients, 2 patients had pCR, 3 had pNR, and 45 patients had pPR as per the new proposed scoring system. Note that 96% of the cases showed no disease progression.

Conclusion Bridge OMCT is a novel treatment method that can be used to tide over the waiting period between the diagnosis and surgery in resource-constrained institutions with heavy patient load. This mode of treatment in locally advanced OSCC seems to provide promising results in this setting. Large multicentric trials are warranted to confirm these results.

Keywords

histomorphological changes - oral metronomic chemotherapy - oral squamous cell carcinoma - pathologic tumor response


Publication History

Article published online:
02 February 2022

© 2022. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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