“IMPROVING FUNCTIONAL STATUS OF CHILDREN IN PALLIATIVE CARE WITH
METRONOMIC CHEMOTHERAPY”
Abstract
Background: Children with incurable cancer can be treated with
metronomic chemotherapy. The aim of this study was to describe the
functional status in children with end-stage cancer who received
metronomic chemotherapy. Procedure: An observational cohort
study was designed with a convenience sample of patients younger than 18
years of age treated with metronomic chemotherapy between 2014-2020 at
Hospital Civil de Guadalajara in Mexico. Results: Forty-three
patients were included with a median age of 13 years. Metronomic
chemotherapy was indicated most frequently in patients with
lymphoblastic leukemia in ten cases (23.3%). Before metronomic
chemotherapy, more than 70% of patients had disease progression after a
second-line treatment. The median treatment duration was 4.2 months.
Treatment was suspended in 39 patients, of which 33 patients died. The
domain correlated with a lower score on the palliative performance scale
at diagnosis was described in 28 cases (65.1%) according to activity
level or evidence of disease, in 14 patients (32.5%) with ambulation,
and in one patient (2.3%) with intake. According to their score 28/43
(65%) patients presented improvement one month after starting
treatment. The McNemar test before and after one month of treatment with
metronomic chemotherapy was statistically significant for these symptoms
(P=0.00). We found that statistical significance was preserved during
the first three months (p = 0.016) of treatment. Conclusions:
The outpatient administration, good treatment adherence and few adverse
effects make metronomic chemotherapy a valuable treatment option. In our
experience, functional status improved significantly in the first three
months of treatment.