Comparison of acute toxicities associated with cetuximab-based bioradiotherapy and platinum-based chemoradiotherapy for head and neck squamous cell carcinomas: A single-institution retrospective study in Japan

Abstract

ABSTARACTConclusion. Grade≧3 mucositis/stomatitis and inability to feed orally were problematic for patients undergoing cetuximab-based bioradiotherapy (BRT) as well as platinum-based chemoradiotherapy (CRT). Severe mucositis/stomatitis and radiation dermatitis should be addressed carefully in patients undergoing cetuximab-based BRT as well.Objectives. The efficacy of cetuximab-based BRT in locally advanced head and neck squamous cell carcinomas has been established. However, the safety of cetuximab-based BRT in comparison with platinum-based CRT is currently under investigation.Method. We retrospectively analyzed 14 patients undergoing cetuximab-based BRT and 29 patients undergoing platinum-based CRT to compare the incidence of acute toxicities.In BRT group, an initial cetuximab loading dose of 400 mg/m 2 was delivered one week before the start of radiotherapy. Seven weekly infusions of 250 mg/m 2 of cetuximab followed during the definitive radiotherapy. In CRT group, cisplatin was administered at a dose of 40mg/m 2 weekly during the definitive radiotherapy.Results. The BRT group had a higher incidence of Grade≧3 radiation dermatitis than did the CRT group (36% vs 3%, respectively, p<0.01). The incidence rate of Grade≧3 mucositis/stomatitis was 64.3 % and 41.4% in the BRT and CRT group, respectively (p=0.1484), while the incidence rate of the inability to feed orally was 38.5% and 55.2%, respectively (p=0.2053).

Safety and efficacy of concurrent carboplatin or cetuximab plus radiotherapy for locally advanced head and neck cancer patients ineligible for treatment with cisplatin

“…However, in another study, Cmab plus RT led to a greater number of cases of grade 3/4 skin toxicity compared with RT alone (35.1% versus 21.2%; p<0.05) [16] , while there were few cases of nausea, vomiting, renal dysfunction, and neuro-or ototoxicity. Other studies also reported grade 3/4 radiation dermatitis in >30% of patients treated with Cmab plus RT [17][18][19] . In addition, there was a higher incidence of severe skin reaction caused by Cmab in an Asian cohort compared with a Western cohort [20] .…”

Association of human papillomavirus and p16 status with mucositis and dysphagia for head and neck cancer patients treated with radiotherapy with or without cetuximab: Assessment from a phase 3 registration trial

“…Although some investigations of single-institution experiences have suggested that the addition of cetuximab to RT may result in increased rates of grade ≥3 mucositis, compared with radiation alone [ 10 – 12 ], this is the only prospectively randomized trial of these treatments, and these results demonstrated no treatment-related differences in rates of this toxicity. In addition, this is the first report showing that the addition of cetuximab did not alter the rate of onset or duration of grade ≥3 mucositis or dysphagia.…”

Artificial nutrition dependence after cetuximab versus cisplatin combined with radiotherapy for advanced head and neck cancer: A propensity score–matched analysis

“…In previous studies, the proportions of patients with enteral nutrition dependence varied widely, from 36% to 78% after CCRT [8][9][10]19 and from 38% to 79% after cetuximab-based RT. 20,21 The proportion of patients who failed to wean from artificial nutrition has been reported as 22% with both cetuximab-based RT and CCRT at 30 days after the end of treatment. 22 A previous study showed that CCRT increased the risk of enteral nutrition dependence at 6 months compared to cetuximab-based RT.…”