Assessment of the utilization pattern of chemotherapy agents in patients with head and neck cancer in an oncology hospital

Abstract

The prevalence of head and neck cancers (HNC) is increasing in developing countries, and its pharmacotherapy has become complex. Evaluation of drug utilization patterns (DUPs) of chemotherapy agents is needed to ascertain the rational use of medications in HNC. The aim was to evaluate the DUPs of chemotherapy agents in patients with HNC in an oncology unit. This prospective observational study was designed to review chemotherapy orders for patients with HNC and assess DUPs over a period of 2 years. Cancer patients aged > 18 years who were receiving chemotherapy together with supportive care medications were enrolled. A total of 208 patients met inclusion criteria and were enrolled in the study. The majority of patients were aged 45–75 years (64.4%), were male (81.3%), and used tobacco (54.9%). The most common sites of HNC were pyriform fossa (18.3%), tongue (17.8%), buccal mucosa (13.9%), and tonsils (10.6%). The majority of patients had head and neck squamous cell carcinoma (HNSCC) [93.3%] and were in stage III (32.2%) or stage IV (48.5%). Neoadjuvant chemotherapy (51%) followed by adjuvant chemotherapy (41.4%) were frequently prescribed. Chemotherapy agents prescribed in > 25% of patients included cisplatin (68.8%), paclitaxel (43.8%), and carboplatin (29.8%); supportive care drugs prescribed in > 25% of patients included dexamethasone (51%), metoclopramide (44.2%), chloramphenicol (39.4%), and pantoprazole (27.9%). Platinum analogs and taxanes were highly prescribed chemotherapy agents as they are highly effective in HNSCC. To prevent chemotherapy-induced cytotoxicity, supportive care agents, such as anti-emetics, proton pump inhibitors, anti-infective agents, and colony-stimulating factors, were used along with miscellaneous supplements.