Radiotherapy compliance is maintained with hypofractionation and concurrent cetuximab in locally advanced head and neck cancer

Chan, Andrew K.; Teoh, Daren; Sanghera, Paul; Hartley, A.

doi:10.1016/j.radonc.2009.05.005

Cited by 10 publications

(5 citation statements)

References 3 publications

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“…This regime employs a fraction size of 2.6 Gy per fraction. The 4-week regime 55 Gy in 20# over 25 days has historically been used with several single agents including methotrexate, cetuximab, carboplatin and capecitabine for locally advanced diseases [13][14][15][16][17][18]. More recent IMRT series have used 55 Gy in 20 fractions with synchronous single agent cisplatin, carboplatin and cetuximab [8,19,20].…”

Section: Discussionmentioning

confidence: 99%

A Phase II Trial of Moderate Hypofractionated Chemoradiation In Postoperative Cases of Carcinoma Oral Cavity

Raza

2023

CTOIJ

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Introduction: Conventional fractionation in post-operative adjuvant radiotherapy (usually 60 Gy in 2 Gy per fraction delivered over six weeks) remains the standard in carcinoma oral cavity. Post-operative hypofractionated radiotherapy is less explored especially in post-operative oral cavity cancers. The aim of this study is to evaluate postoperative moderate hypofractionation as the adjuvant treatment in post-operative oral cavity cancer.Method: Patients of oral cavity cancers meriting adjuvant postoperative irradiation were inducted in the study. Hypofractionation consisted of a total dose of 52 Gy in 20 fractions over 4 weeks with concurrent chemotherapy. The primary endpoint was acute toxicity and late toxicity according to CTCAE V4.03 classification. The secondary endpoints included progression free survival at 1 year. Acute toxicity within 3 months of treatment and late toxicity at 1year follow up.Result: Thirty patients were recruited over 18 months. All patients completed a minimum of 1 year of follow-up. Twenty-Nine patients completed planned radiotherapy doses within a median treatment time of 30 days (27)(28)(29)(30)(31)(32)(33). Grade 2, 3and 4 skin reactions were seen in 86.2%, 10.34%, and 3.4% respectively. Grade 2,3,4 mucositis was seen in 55.17%, 41.3%, 3.4% patients respectively during treatment (acute toxicity). Recurrence was seen in 17% of patients at 3 months. Progression free survival at 1 year was 51%. Overall survival in 1 year was 79%. Conclusion:The schedule of 52 Gy in 20 fractions with concomitant chemotherapy is tolerable in patients with better compliance and equivalent PFS to conventional fractionation postoperative radiotherapy. Phase 3 trial is required for further validation of results.

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Section: Discussionmentioning

confidence: 99%

A Phase II Trial of Moderate Hypofractionated Chemoradiation In Postoperative Cases of Carcinoma Oral Cavity

Raza

2023

CTOIJ

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“…The 4 week regime 55 Gy in 20# over 25 days has historically been used with several single agents including methotrexate, cetuximab, carboplatin and capecitabine for locally advanced disease disease [28] , [29] , [30] , [31] , [32] , [33] . More recent IMRT series have used 55 Gy in 20 fractions with synchronous single agent cisplatin, carboplatin and cetuximab [13] , [34] , [35] .…”

Section: Discussionmentioning

confidence: 99%

Hypofractionated chemoradiation for head and cancer: Data from the PET NECK trial

et al. 2021

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“…Chemotherapy was given with intravenous carboplatin, area under curve 4·5 during weeks 1 and 4 14 , 15 . Patients with a contra-indication to carboplatin received cetuximab, loading dose 400/mgm −2 1 week before commencing radiotherapy followed by 250 mgm −2 weekly for 4 weeks 16 , 17 …”

Section: Methodsmentioning

confidence: 99%

“…14,15 Patients with a contraindication to carboplatin received cetuximab, loading dose 400/mgm 22 1 week before commencing radiotherapy followed by 250 mgm 22 weekly for 4 weeks. 16,17 Patients were reviewed weekly during the 4 weeks of chemoradiotherapy and for 4 weeks after completion in outpatient clinic by their consultant clinical oncologist or specialist registrar in clinical oncology. Mucositis, dysphagia and nausea toxicity were prospectively recorded using the Common Toxicity Criteria (CTCAE v3?0).…”

Section: Introductionmentioning

confidence: 99%

The use of MuGard™, Caphosol^®and Episil^®in patients undergoing chemoradiotherapy for squamous cell carcinoma of the head and neck

et al. 2013

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Introduction: Oral mucositis is common for patients undergoing chemoradiotherapy for squamous cell carcinoma of the head and neck (SCCHN). Despite the significant detrimental sequelae associated, there is no consensus on the optimum mouth care regimen. This prospective audit aims to record mucositis and dysphagia toxicity and the level of analgesia prescribed when recent products: MuGard TM , Caphosol R and Episil R are compared with our standard departmental mouth care regimen.Methods: Patients undergoing concurrent chemoradiotherapy for locally advanced SCCHN at University Hospital Birmingham, UK were prospectively audited weekly for 8 consecutive weeks starting from week 1 of chemoradiotherapy from June 2009 until January 2011. Patients received either standard oral care regimen of aspirin, glycerin and sucralfate, or, MuGard TM , Caphosol R or Episil R . Grade of mucositis, dysphagia and analgesia score were prospectively recorded using the common toxicity criteria v3?0.Results: One hundred and four patients were included. There was no difference in the grade and duration of mucositis (p 5 0?82), dysphagia (p 5 0?99) or analgesia score (p 5 0?61) for either MuGard TM , Caphosol R or Episil R compared with standard oral care.Conclusion: There is no evidence from this audit that Mugard TM , Caphosol R or Episil R improves mucositis and dysphagia toxicity or the level of analgesia prescribed compared with our standard departmental mouth care regimen. Randomised trials comparing these approaches are required to detect any meaningful clinical benefit.

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Radiotherapy compliance is maintained with hypofractionation and concurrent cetuximab in locally advanced head and neck cancer

Cited by 10 publications

References 3 publications

A Phase II Trial of Moderate Hypofractionated Chemoradiation In Postoperative Cases of Carcinoma Oral Cavity

A Phase II Trial of Moderate Hypofractionated Chemoradiation In Postoperative Cases of Carcinoma Oral Cavity

Hypofractionated chemoradiation for head and cancer: Data from the PET NECK trial

The use of MuGard™, Caphosol^®and Episil^®in patients undergoing chemoradiotherapy for squamous cell carcinoma of the head and neck

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Radiotherapy compliance is maintained with hypofractionation and concurrent cetuximab in locally advanced head and neck cancer

Cited by 10 publications

References 3 publications

A Phase II Trial of Moderate Hypofractionated Chemoradiation In Postoperative Cases of Carcinoma Oral Cavity

A Phase II Trial of Moderate Hypofractionated Chemoradiation In Postoperative Cases of Carcinoma Oral Cavity

Hypofractionated chemoradiation for head and cancer: Data from the PET NECK trial

The use of MuGard™, Caphosol®and Episil®in patients undergoing chemoradiotherapy for squamous cell carcinoma of the head and neck

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Product

Resources

About

The use of MuGard™, Caphosol^®and Episil^®in patients undergoing chemoradiotherapy for squamous cell carcinoma of the head and neck