Concurrent cetuximab and radiation therapy in patients with locoregionally advanced head and neck cancer

Abstract

Objective: To retrospectively study the clinical characteristics and treatment outcomes in patients with locoregionally advanced head and neck cancer treated concurrently with cetuximab and radiotherapy. Methods: Patients with locoregionally advanced head and neck cancer treated between May 2008 and July 2010 were evaluated. Cetuximab was initiated one week before and then weekly during radiotherapy treatment. The majority of patients were prescribed a radiotherapy dose of 70 Gy. Results: The age of 31 patients ranged from 45 to 84 (median, 67) years and 77% were male. The majority (65%) had comorbid diseases and 35% had a Karnofsky performance status score of 70 or less. In all, 30 patients had squamous cell carcinoma and one had undifferentiated carcinoma. Primary tumour sites were larynx (n = 12), oropharynx (n = 8), oral cavity (n = 7), hypopharynx (n = 3), and maxillary sinus (n = 1). Follow-up times ranged from 5 to 31 (median, 16) months. Response rate was 80% (complete remission, 64%; partial remission, 16%). Median duration of locoregional control was not reached (1-year and projected 2-year locoregional control rates were 70% and 55%, respectively). Median progression-free survival was 13 months (1-year and projected 2-year progression-free survival rates were 51% and 40%, respectively). Median overall survival was 25 months (1-year and projected 2-year overall survival rates were 65% and 60%, respectively). Treatment toxicities of grade 3 or more included oral mucositis (52%), radiation dermatitis (26%), and infection (13%). The majority of patients (84%) received eight doses of cetuximab. Conclusions: Cetuximab given concurrently with radiotherapy was well-tolerated and not associated with a significant increase in the frequency or severity of radiotherapy-induced mucositis and dermatitis. Our data demonstrated favourable tumour response rates and locoregional control duration comparable to that in the pivotal Bonner study. © 2012 Hong Kong College of Radiologists.