(P083) Concurrent Chemotherapy + IMRT in Locally Advanced Squamous Cell Carcinoma of Head and Neck: What Is the Appropriate Chemotherapy?

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OncologyOncology Vol 29 No 4_Suppl_1
Volume 29
Issue 4_Suppl_1

Cetuximab may be considered as an alternative to cisplatin with concurrent RT, particularly for patients with locally advanced head and neck squamous cell carcinoma who are not candidates for platinum therapy. These results indicate no difference in patterns of local or distant failure between cetuximab, low-dose weekly cisplatin, or q3 weekly high-dose cisplatin in this patient population.

Jeanann L. Suggs, MD, PhD, Shankar P. Giri, MD, Madhava Kanakamedala, MD; University of Mississippi Medical Center

PURPOSE: To evaluate patterns of failure and survival among patients with locally advanced squamous cell carcinoma of the head and neck treated definitively with cetuximab, low-dose cisplatin, or high-dose cisplatin together with intensity-modulated radiation therapy (IMRT).

MATERIALS AND METHODS: A total of 158 patients treated between 2005 and 2010 were reviewed retrospectively. All had biopsy-proven squamous cell carcinoma of the head and neck and were treated with IMRT with concurrent chemotherapy. Low-dose weekly cisplatin, high-dose cisplatin every 3 weeks, or weekly cetuximab was utilized for each patient. Local treatment failure, distant failure, and median survival were analyzed using Fisher’s exact test.

RESULTS: Among 158 evaluated patients, 66 (41.8%) were treated with cetuximab, 57 (36.1%) were treated with low-dose cisplatin, and 32 (20.3%) were treated with high-dose cisplatin.

Median age at diagnosis was 53.5 years. Primary tumor locations included the oropharynx (32%), larynx (32%), oral cavity (8%), paranasal spine (5%), hypopharynx (4%), nasopharynx (4%), and other (32%). Median radiation dose was 70 Gy (range: 60–70 Gy).

Locoregional failure was not statistically different between the cetuximab, low-dose cisplatin, and high-dose cisplatin groups (15.15%, 7.01%, and 12.5%, respectively; P = .377).

Distant failure was not statistically different between the cetuximab, low-dose cisplatin, and high-dose cisplatin groups (10.6%, 17.54%, and 15.63%, respectively; P = .525).

Median survival for cetuximab, low-dose cisplatin, and high-dose cisplatin was 18 months, 19 months, and 22 months, respectively (P = .384).

CONCLUSIONS: Cetuximab may be considered as an alternative to cisplatin with concurrent RT, particularly for patients with locally advanced head and neck squamous cell carcinoma who are not candidates for platinum therapy. These results indicate no difference in patterns of local or distant failure between cetuximab, low-dose weekly cisplatin, or q3 weekly high-dose cisplatin in this patient population.

Proceedings of the 97th Annual Meeting of the American Radium Society- americanradiumsociety.org

Articles in this issue

(P005) Ultrasensitive PSA Identifies Patients With Organ-Confined Prostate Cancer Requiring Postop Radiotherapy
(P001) Disparities in the Local Management of Breast Cancer in the United States According to Health Insurance Status
(P002) Predictors of CNS Disease in Metastatic Melanoma: Desmoplastic Subtype Associated With Higher Risk
(P003) Identification of Somatic Mutations Using Fine Needle Aspiration: Correlation With Clinical Outcomes in Patients With Locally Advanced Pancreatic Cancer
(P004) A Retrospective Study to Assess Disparities in the Utilization of Intensity-Modulated Radiotherapy (IMRT) and Proton Therapy (PT) in the Treatment of Prostate Cancer (PCa)
(S001) Tumor Control and Toxicity Outcomes for Head and Neck Cancer Patients Re-Treated With Intensity-Modulated Radiation Therapy (IMRT)-A Fifteen-Year Experience
(S003) Weekly IGRT Volumetric Response Analysis as a Predictive Tool for Locoregional Control in Head and Neck Cancer Radiotherapy 
(S004) Combination of Radiotherapy and Cetuximab for Aggressive, High-Risk Cutaneous Squamous Cell Cancer of the Head and Neck: A Propensity Score Analysis
(S005) Radiotherapy for Carcinoma of the Hypopharynx Over Five Decades: Experience at a Single Institution
(S002) Prognostic Value of Intraradiation Treatment FDG-PET Parameters in Locally Advanced Oropharyngeal Cancer
(P006) The Role of Sequential Imaging in Cervical Cancer Management
(P008) Pretreatment FDG Uptake of Nontarget Lung Tissue Correlates With Symptomatic Pneumonitis Following Stereotactic Ablative Radiotherapy (SABR)
(P009) Monte Carlo Dosimetry Evaluation of Lung Stereotactic Body Radiosurgery
(P010) Stereotactic Body Radiotherapy for Treatment of Adrenal Gland Metastasis: Toxicity, Outcomes, and Patterns of Failure
(P011) Stereotactic Radiosurgery and BRAF Inhibitor Therapy for Melanoma Brain Metastases Is Associated With Increased Risk for Radiation Necrosis
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