Velasco Costa J, Ramírez Roig C, Olmos Jiménez R, Díaz Carrasco MS
Hospital Clínico Universitario Virgen de la Arrixaca. Murcia (España)
Rev. OFIL 2016, 26;4:287-293
Fecha de recepción: 15/03/2016 – Fecha de aceptación: 28/05/2016
Javier Velasco Costa
Hospital Clínico Universitario Virgen de la Arrixaca
Ctra. Madrid-Cartagena, s/n
30120 El Palmar – Murcia
Correo electrónico: email@example.com
Background: The aim of this study was to evaluate the effectiveness and toxicity of definitive chemo-radiation using cetuximab in patients with non metastatic head and neck squamous cell carcinoma (HNSCC), as well as to assess potential factors affecting survival.
Methods: We retrospectively analyzed the medical records of n=30 patients HNSCC treated with definitive radiotherapy with concomitant cetuximab at our institution between 2009 and 2015. None of them were elected to receive cisplatin due to their bad performance status. We performed univariate and multivariate analysis to identify prognostic factors for overall survival (OS) and progression-free survival (PFS). Moreover, treatment-related toxicity was assessed.
Results: A total of 30 patients (25 men and 5 women) were included, mean of age was 68.5 years old (50-84), 56.7% had moderately differentiated and stage IVa cancers, 53.3% T4 and 40% N0. More frequent localizations were: oral cavity (30%), larynx (30%) and oropharynx (23.3%). Mean of Charlson and WUHNCI rates 2.8 and 2.0, respectively.
For the entire cohort, the median OS and PFS were 19.3 and 14.8 months, respectively. In multivariate analysis, important prognostic factors for OS (p<0.05) were: number of cycles, type of response, tumor stage and skin toxicity.
Patients received a median of 7 cycles of radiotherapy plus cetuximab; grade 3 toxicity was dominated by nutritional impairment (dysphagia), lymphopenia, skin toxicity (both radiodermitis and acneiform rash), oromucositis and asthenia.
Conclusions: Cetuximab with concomitant radiotherapy provides a satisfactory response with acceptable toxicity for this kind of patients. However, further advances in radio-oncological treatment strategies are necessary for improving outcome.
Key Words: Cetuximab, toxicity, head and neck cancer.