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01-09-2014 | Original article

Concurrent use of cisplatin or cetuximab with definitive radiotherapy for locally advanced head and neck squamous cell carcinomas

Authors: Antonin Levy, Pierre Blanchard, Sara Bellefqih, Nacéra Brahimi, Joël Guigay, François Janot, Stéphane Temam, Jean Bourhis, Eric Deutsch, Nicolas Daly-Schveitzer, Yungan Tao, MD, PhD

Published in: Strahlentherapie und Onkologie | Issue 9/2014

Abstract

Aim

The goal of the present work was to compare outcomes of definitive concurrent cisplatin-based chemoradiotherapy (CRT) with cetuximab-based bioradiotherapy (BRT) in locally advanced head-and-neck squamous cell carcinoma (HNSCC).

Patients and methods

Between 2006 and 2012, 265 patients with locally advanced HNSCC were treated at our institution with CRT (n = 194; 73 %) with three cycles of cisplatin (100 mg/m², every 3 weeks) or BRT (n = 71; 27 %) with weekly cetuximab. Patients receiving BRT had more pre-existing conditions (Charlson index ≥ 2) than the CRT group (p = 0.005).

Results

Median follow-up was 29 months. In all, 56 % of patients treated with CRT received the planned three cycles (92 % at least two cycles) and 79 % patients treated with BRT received six cycles or more. The 2-year actuarial overall survival (OS) and progression-free survival (PFS) were 72 % and 61 %, respectively. In the multivariate analysis (MVA), T4 stage, N2–3 stage, smoking status (current smoker as compared with never smoker), and non-oropharyngeal locations predicted for OS, whereas BRT association with OS was of borderline significance (p = 0.054). The 2-year actuarial locoregional control (LRC) and distant control (DC) rates were 73 and 79 %, respectively. CRT was independently associated with an improved LRC (2-year LRC: 76 % for CRT vs. 61 % for BRT) and DC (2-year LRC: 81 % for CRT vs. 68 % for BRT) in comparison with BRT (p < 0.001 and p = 0.01 in the MVA). Subgroup analyses showed that T4 patients benefited significantly from CRT (vs. BRT) in LRC, while T1–3 did not. BRT patients had more G3–4 skin complications (p < 0.001) and CRT patients had higher rates of feeding tube placement (p = 0.006) and G3–4 gastrointestinal toxicities (p < 0.001).

Conclusion

This retrospective analysis showed a better LRC in locally advanced HNSCC treated by cisplatin-based CRT than cetuximab-based BRT, and a nonsignificant trend towards an improved OS.

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Title: Concurrent use of cisplatin or cetuximab with definitive radiotherapy for locally advanced head and neck squamous cell carcinomas
Authors: Antonin Levy
Pierre Blanchard
Sara Bellefqih
Nacéra Brahimi
Joël Guigay
François Janot
Stéphane Temam
Jean Bourhis
Eric Deutsch
Nicolas Daly-Schveitzer
Yungan Tao, MD, PhD
Publication date: 01-09-2014
Publisher: Springer Berlin Heidelberg
Published in: Strahlentherapie und Onkologie / Issue 9/2014
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-014-0626-0

At a glance: The STEP trials

Springer Medicine

Concurrent use of cisplatin or cetuximab with definitive radiotherapy for locally advanced head and neck squamous cell carcinomas

Abstract

Aim

Patients and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Aim

Patients and methods

Results

Conclusion

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