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Conference Paper: Re-treatment of nasopharyngeal carcinoma by sequential chemo-radiotherapy with or without cetuximab

TitleRe-treatment of nasopharyngeal carcinoma by sequential chemo-radiotherapy with or without cetuximab
Authors
KeywordsMedical sciences
Radiology and nuclear medicine
Issue Date2009
PublisherElsevier Inc.
Citation
The 51st Annual Meeting of the American Society for Radiation Oncology (ASTRO 2009), Chicago, IL., 1-5 November 2009. In International Journal of Radiation Oncology - Biology - Physics, 2009, v. 75 n. 3 suppl., p. S423-S424, abstract no. 2539 How to Cite?
AbstractPURPOSE/OBJECTIVE(S): Patients with loco-regionally recurrent nasopharyngeal carcinoma (NPC) frequently require external beam radiotherapy for re-treatment but treatment results are unsatisfactory with poor control rate and high risk of late complications. Over-expression of epidermal growth factor receptor (EGFR) is common in NPC and combination of anti-EGFR targeted therapy with ERT may improve outcome. MATERIALS/METHODS: Sixteen consecutive patients with loco-regional recurrence of NPC not amenable to surgery or brachytherapy were enrolled into a phase II study using induction chemotherapy consisted of gemcitabine and carboplatin for 3 cycles followed by re-irradiation using intensity-modulated radiotherapy. Cetuximab was administered at a loading dose of 400mg/m2 1 week before radiotherapy followed by weekly dose of 250mg/m2 during treatment (Group 1). Treatment outcome of this study group was compared with a historical cohort of 17 patients treated also by sequential chemo-radiotherapy using similar regimens and techniques but without cetuximab (Group 2). Loco-regional progression-free (LRPF) rate and overall survival rate (OS) were estimated using Kaplan-Meier method and differences compared with log–rank test. RESULTS: More patients in Group 1 had advanced nodal disease at recurrence (rN1-2: 37.5% in Group 1 vs. 6% in Group 2) whereas more patients in Group 2 had advanced primary tumor at recurrence (rT3–4:62% in Group 1 vs. 100% in Group 2). All patients completed chemo-radiotherapy and the median dose was 54 Gy in both groups. The median no. of cycles of cetuximab in Group 1 was 6 (range, 2 – 7). Acute toxicities during radiotherapy were mild and the incidence of Grade 3 mucositis was 12.5% in Group 2 and 6% in Group 2. One patient in group 1 developed Grade 3 acneiform rash. Median follow-up time for surviving patients was 22 months in Group 1 and 61 months in Group 2. One-year and 2-year LRPF rates were 43% and 36% in Group 1 compared with 44% and 36% in Group 2 (p = 0.91). One-year and 2-year OS rates were 93% and 79% in Group 1 compared with 94% and 82% in Group 2 (p = 0.37). CONCLUSIONS: Re-treatment of loco-regionally recurrent NPC by sequential chemo-radiotherapy with concurrent cetuximab was generally well-tolerated. The short term tumor control and survival rates appeared to be comparable but not superior to historical control using similar treatment but without cetuximab.
DescriptionThis journal suppl. entitled: Proceedings of the American Society for Radiation Oncology 51st Annual Meeting
Persistent Identifierhttp://hdl.handle.net/10722/194791
ISSN
2015 Impact Factor: 4.495
2015 SCImago Journal Rankings: 2.274

 

DC FieldValueLanguage
dc.contributor.authorChua, Den_US
dc.contributor.authorLee, Ven_US
dc.contributor.authorTsang, Jen_US
dc.contributor.authorNg, SCYen_US
dc.contributor.authorLeung, TWen_US
dc.contributor.authorAu, GKHen_US
dc.date.accessioned2014-02-17T02:09:51Z-
dc.date.available2014-02-17T02:09:51Z-
dc.date.issued2009en_US
dc.identifier.citationThe 51st Annual Meeting of the American Society for Radiation Oncology (ASTRO 2009), Chicago, IL., 1-5 November 2009. In International Journal of Radiation Oncology - Biology - Physics, 2009, v. 75 n. 3 suppl., p. S423-S424, abstract no. 2539en_US
dc.identifier.issn0360-3016-
dc.identifier.urihttp://hdl.handle.net/10722/194791-
dc.descriptionThis journal suppl. entitled: Proceedings of the American Society for Radiation Oncology 51st Annual Meeting-
dc.description.abstractPURPOSE/OBJECTIVE(S): Patients with loco-regionally recurrent nasopharyngeal carcinoma (NPC) frequently require external beam radiotherapy for re-treatment but treatment results are unsatisfactory with poor control rate and high risk of late complications. Over-expression of epidermal growth factor receptor (EGFR) is common in NPC and combination of anti-EGFR targeted therapy with ERT may improve outcome. MATERIALS/METHODS: Sixteen consecutive patients with loco-regional recurrence of NPC not amenable to surgery or brachytherapy were enrolled into a phase II study using induction chemotherapy consisted of gemcitabine and carboplatin for 3 cycles followed by re-irradiation using intensity-modulated radiotherapy. Cetuximab was administered at a loading dose of 400mg/m2 1 week before radiotherapy followed by weekly dose of 250mg/m2 during treatment (Group 1). Treatment outcome of this study group was compared with a historical cohort of 17 patients treated also by sequential chemo-radiotherapy using similar regimens and techniques but without cetuximab (Group 2). Loco-regional progression-free (LRPF) rate and overall survival rate (OS) were estimated using Kaplan-Meier method and differences compared with log–rank test. RESULTS: More patients in Group 1 had advanced nodal disease at recurrence (rN1-2: 37.5% in Group 1 vs. 6% in Group 2) whereas more patients in Group 2 had advanced primary tumor at recurrence (rT3–4:62% in Group 1 vs. 100% in Group 2). All patients completed chemo-radiotherapy and the median dose was 54 Gy in both groups. The median no. of cycles of cetuximab in Group 1 was 6 (range, 2 – 7). Acute toxicities during radiotherapy were mild and the incidence of Grade 3 mucositis was 12.5% in Group 2 and 6% in Group 2. One patient in group 1 developed Grade 3 acneiform rash. Median follow-up time for surviving patients was 22 months in Group 1 and 61 months in Group 2. One-year and 2-year LRPF rates were 43% and 36% in Group 1 compared with 44% and 36% in Group 2 (p = 0.91). One-year and 2-year OS rates were 93% and 79% in Group 1 compared with 94% and 82% in Group 2 (p = 0.37). CONCLUSIONS: Re-treatment of loco-regionally recurrent NPC by sequential chemo-radiotherapy with concurrent cetuximab was generally well-tolerated. The short term tumor control and survival rates appeared to be comparable but not superior to historical control using similar treatment but without cetuximab.en_US
dc.languageengen_US
dc.publisherElsevier Inc.en_US
dc.relation.ispartofInternational Journal of Radiation Oncology - Biology - Physicsen_US
dc.subjectMedical sciences-
dc.subjectRadiology and nuclear medicine-
dc.titleRe-treatment of nasopharyngeal carcinoma by sequential chemo-radiotherapy with or without cetuximaben_US
dc.typeConference_Paperen_US
dc.identifier.emailChua, D: dttchua@hkucc.hku.hken_US
dc.identifier.emailLee, V: vhflee@hku.hken_US
dc.identifier.emailTsang, J: jwhtsang@hku.hken_US
dc.identifier.emailNg, SCY: ngchoryi@hku.hken_US
dc.identifier.emailLeung, TW: ltw920@hkucc.hku.hken_US
dc.identifier.emailAu, GKH: hkugkhau@hku.hken_US
dc.identifier.authorityChua, D=rp00415en_US
dc.identifier.authorityLee, V=rp00264en_US
dc.identifier.authorityTsang, J=rp00278en_US
dc.identifier.hkuros227971en_US
dc.identifier.volume75en_US
dc.identifier.issue3 suppl.en_US
dc.identifier.spageS423, abstract no. 2539en_US
dc.identifier.epageS424en_US
dc.publisher.placeUnited Statesen_US

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