Combined Cetuximab and Reirradiation for Locoregional Recurrent and Inoperable Squamous Cell Carcinoma of the Head and Neck

被引:39
作者
Balermpas, Panagiotis [1 ]
Hambek, Markus [2 ]
Seitz, Oliver [3 ]
Roedel, Claus [1 ]
Weiss, Christian [1 ]
机构
[1] Goethe Univ Frankfurt, Dept Radiat Therapy & Oncol, D-60590 Frankfurt, Germany
[2] Goethe Univ Frankfurt, Dept Otorhinolaryngol, D-60590 Frankfurt, Germany
[3] Goethe Univ Frankfurt, Dept Oral Maxillofacial & Plast Facial Sur, D-60590 Frankfurt, Germany
关键词
Reirradiation; Cetuximab; Antibody; Head-and-neck cancer; Radiotherapy; COOPERATIVE-ONCOLOGY-GROUP; PLUS CETUXIMAB; STEREOTACTIC REIRRADIATION; PHASE-II; CANCER; CISPLATIN; TUMORS; CHEMOTHERAPY; TRIAL; RADIOCHEMOTHERAPY;
D O I
10.1007/s00066-009-2092-7
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: To investigate the feasibility, toxicity, and efficacy of external-beam reirradiation (Re-RT) combined with cetuximab for patients with inoperable and recurrent squamous cell carcinoma of the head and neck (SCCHN). Patients and Methods: Seven patients with inoperable recurrence of SCCHN after adjuvant or definitive radiotherapy (RT) and simultaneous or sequential cisplatin-based chemotherapy for primary SCCHN were treated between August and December 2008 with Re-RT (1.8 Gy/fraction to 50.4 Gy) and cetuximab (400 mg/m(2) initial dose in the 1st week, and then 250 mg/m(2) once weekly). Recurrence had to be located at least >= 50% in the preirradiated field. Long term toxicity from previous treatment was recorded before Re-RT as a baseline value. Acute and late toxicity derived from the experimental regimen were recorded every week during RT, and then every 3 months. Efficacy was assessed with repeated imaging using response evaluation criteria in solid tumors (RECIST) and clinical examinations 8-12 weeks after end of the treatment and every 3 months thereafter (Tables 1 and 2). Results: Only mild localized mucositis occurred in all patients. Two patients developed a grade 3 acneiform rash related to cetuximab. After treatment one patient developed a grade 2 trismus, another showed grade 3 abacterial salivary gland inflammation with severe pain requiring opioid medication. Two patients achieved a complete response after 7 months, one remained stable, three progressed, and one died from pneumonia without having restaging magnetic resonance imaging. Conclusion: A second course of RT combined with cetuximab in patients with inoperable, recurrent HNSCC proved to be feasible with mild or moderate toxicity and encouraging response to treatment.
引用
收藏
页码:775 / 781
页数:7
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