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Conference Paper: Re-treatment of nasopharyngeal carcinoma by sequential chemo-radiotherapy with or without cetuximab
Title | Re-treatment of nasopharyngeal carcinoma by sequential chemo-radiotherapy with or without cetuximab |
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Authors | |
Keywords | Medical sciences Radiology and nuclear medicine |
Issue Date | 2009 |
Publisher | Elsevier 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? |
Abstract | PURPOSE/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. |
Description | This journal suppl. entitled: Proceedings of the American Society for Radiation Oncology 51st Annual Meeting |
Persistent Identifier | http://hdl.handle.net/10722/194791 |
ISSN | 2023 Impact Factor: 6.4 2023 SCImago Journal Rankings: 1.992 |
DC Field | Value | Language |
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dc.contributor.author | Chua, D | en_US |
dc.contributor.author | Lee, V | en_US |
dc.contributor.author | Tsang, J | en_US |
dc.contributor.author | Ng, SCY | en_US |
dc.contributor.author | Leung, TW | en_US |
dc.contributor.author | Au, GKH | en_US |
dc.date.accessioned | 2014-02-17T02:09:51Z | - |
dc.date.available | 2014-02-17T02:09:51Z | - |
dc.date.issued | 2009 | en_US |
dc.identifier.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 | en_US |
dc.identifier.issn | 0360-3016 | - |
dc.identifier.uri | http://hdl.handle.net/10722/194791 | - |
dc.description | This journal suppl. entitled: Proceedings of the American Society for Radiation Oncology 51st Annual Meeting | - |
dc.description.abstract | PURPOSE/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.language | eng | en_US |
dc.publisher | Elsevier Inc. | en_US |
dc.relation.ispartof | International Journal of Radiation Oncology - Biology - Physics | en_US |
dc.subject | Medical sciences | - |
dc.subject | Radiology and nuclear medicine | - |
dc.title | Re-treatment of nasopharyngeal carcinoma by sequential chemo-radiotherapy with or without cetuximab | en_US |
dc.type | Conference_Paper | en_US |
dc.identifier.email | Chua, D: dttchua@hkucc.hku.hk | en_US |
dc.identifier.email | Lee, V: vhflee@hku.hk | en_US |
dc.identifier.email | Tsang, J: jwhtsang@hku.hk | en_US |
dc.identifier.email | Ng, SCY: ngchoryi@hku.hk | en_US |
dc.identifier.email | Leung, TW: ltw920@hkucc.hku.hk | en_US |
dc.identifier.email | Au, GKH: hkugkhau@hku.hk | en_US |
dc.identifier.authority | Chua, D=rp00415 | en_US |
dc.identifier.authority | Lee, V=rp00264 | en_US |
dc.identifier.authority | Tsang, J=rp00278 | en_US |
dc.identifier.hkuros | 227971 | en_US |
dc.identifier.volume | 75 | en_US |
dc.identifier.issue | 3 suppl. | en_US |
dc.identifier.spage | S423, abstract no. 2539 | en_US |
dc.identifier.epage | S424 | en_US |
dc.publisher.place | United States | en_US |
dc.identifier.issnl | 0360-3016 | - |