Impact of Oral Metronomic Chemotherapy in Locally Advanced Carcinoma of the Laryngopharynx: A Case Report

Abstract

Oral cancer continues to be a significant health concern in Southeast Asia. The primary treatment involves surgical resection with or without reconstruction, along with adjuvant therapy. However, the survival rates for patients with stage I-II oral cancer range from 70% to 80%, whereas in more advanced stage III-IV cancers, these rates drop significantly to 40%-50%. Unresectable oral cancers are primarily managed with palliative intent, utilising systemic therapy and/or radiotherapy. Unfortunately, a substantial portion of these cases (around 60%-80%) are diagnosed at an advanced stage due to delayed diagnosis, limited access to definitive treatment, and financial constraints. These challenges underscore the critical need for therapies that can effectively halt cancer progression, promote regression, and maintain the disease in an operable state while awaiting definitive treatment, typically involving surgery. In this context, Oral Metronomic Chemotherapy (OMCT) emerges as a promising alternative. OMCT offers costeffectiveness and involves the regular administration of chemotherapeutic drugs at low doses without interruption. The concept of “metronomic” chemotherapy draws inspiration from a metronome, which produces regular ticks representing a constant pulse. Herein, the authors presented case report of a 55-year-old male patient to compile evidence-based data on the use of OMCT in treating locally advanced carcinoma of the laryngopharynx. It explores the mechanism of action, utility, and potential future directions of OMCT. By analysing a real-world case, it seeks to highlight the effectiveness and advantages of OMCT as a treatment option for oral squamous cell carcinoma.