SBRT AND CETUXIMAB FOR RECURRENT HEAD-NECK CANCER

Radiother Oncol. 2013 Nov 18. pii: S0167-8140(13)00398-8. doi: 10.1016/j.radonc.2013.08.012. [Epub ahead of print]

Multi institutional phase II study of concomitant stereotactic reirradiation and cetuximab for recurrent head and neck cancer.

Lartigau EF, Tresch E, Thariat J, Graff P, Coche-Dequeant B, Benezery K, Schiappacasse L, Degardin M, Bondiau PY, Peiffert D, Lefebvre JL, Lacornerie T,Kramar A.

Source

Centre Oscar Lambret, University Lille II & ONCOLille Consortium, France. Electronic address: e-lartigau@o-lambret.fr.

Abstract

PURPOSE:

Recurrent head and neck cancer is associated to a poor survival prognosis. A high toxicity rate is demonstrated when surgery and/or radiotherapy and/or chemotherapy are combined. Furthermore, the duration of treatment is often not ethically compatible with the expected survival (median survival<1year a="" after="" aim="" amp="" and="" are="" as="" body="" cetuximab="" completion="" control="" could="" course="" deliver="" demonstrated="" feasibility="" get="" healthy="" ille="" in="" irradiation="" limits="" local="" longer="" multicentric="" nancy="" nice="" non="" normal="" of="" offer="" one="" order="" p="" precise="" protocols.="" radiotherapy="" reirradiation="" reported.="" results="" same="" sbrt="" short="" sparing="" stereotactic="" study="" the="" tissues.="" tissues="" to="" tolerance="" toxic="" use="" using="" was="" weeks="" while="" with="">

METHODS AND MATERIALS:

Patients with inoperable recurrent, or new primary tumor in a previously irradiated area, were included (WHO<3 36gy="" 48="" 5="" 6gy="" 85="" 95="" all="" and="" cetuximab="" chemotherapy.="" concomitant="" covering="" dose="" fractions="" had="" in="" injections="" isodose="" line="" of="" p="" patients="" previous="" ptv="" radiotherapy="" reirradiation="" six="" surgery="" the="" to="" was="" with="">

RESULTS:

Between 11/2007 and 08/2010, 60 were included (46 men and 14 women), 56 received CT+RT, 3 were not treated and 1 received only CT. Median age was 60 (42-87)) and all 56 patients had squamous carcinoma and received concomitant cetuximab. Mean time between previous radiotherapy and the start of SBRT was 38months. Cutaneous toxicity was observed for 41 patients. There was one toxic death from hemorrhage and denutrition. Median follow-up was 11.4months. At 3months, response rate was 58.4% (95% CI: 43.2-72.4%) and disease control rate was 91.7% (95% CI: 80.0-97.7%). The one-year OS rate was 47.5% (95% CI: 30.8-62.4).

CONCLUSION:

These results suggest that short SBRT with cetuximab is an effective salvage treatment with good response rate in this poor prognosis population with previously irradiated HNC. Treatment is feasible and, with appropriate care to limiting critical structure, acute toxicities are acceptable. This combination may be the reference treatment is this population.