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International Journal of Clinical Oncology

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01-05-2019 | Neutropenia | Original Article

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

Authors: Satoshi Hamauchi, Tomoya Yokota, Takatsugu Mizumachi, Yusuke Onozawa, Hirofumi Ogawa, Tsuyoshi Onoe, Tomoyuki Kamijo, Yoshiyuki Iida, Tetsuo Nishimura, Tetsuro Onitsuka, Hirofumi Yasui, Akihiro Homma

Published in: International Journal of Clinical Oncology | Issue 5/2019

Abstract

Background

Locally advanced squamous cell carcinoma of the head and neck (LASCCHN) is usually treated with cisplatin (CDDP)-based chemoradiotherapy, except when patients are elderly or have renal, cardiac, or neurogenic dysfunction. This study compared the safety and efficacy of concurrent carboplatin (CBDCA) to cetuximab (Cmab) plus radiotherapy (RT) in patients ineligible for CDDP treatment.

Methods

We retrospectively analyzed LASCCHN patients who received CBDCA plus RT (n = 29) or Cmab plus RT (n = 18) due to ineligibility for CDDP treatment at two Japanese institutions between August 2006 and December 2015.

Results

Patients characteristics for CBDCA plus RT and Cmab plus RT were: median age, 74 and 75 years; 0–1 performance status, 90% and 100%; main primary tumor site, hypopharynx 52% (n = 15) and oropharynx 39% (n = 7); and stage IV, 90% (n = 26) and 50% (n = 9), respectively. With a median follow-up time of 60.0 months for CBDCA plus RT and 53.6 months for Cmab plus RT, 3-year locoregional control rates were 56% versus 58%, and median progression-free survival was 42.7 versus 11.6 months. CBDCA plus RT was associated with more grade 3/4 hematologic toxicities, including neutropenia and thrombocytopenia, whereas Cmab plus RT was associated with more grade 3/4 oral mucositis and radiation dermatitis.

Conclusions

CBDCA or Cmab as a concurrent systemic therapy with RT is a possible treatment option for LASCCHN patients ineligible for CDDP treatment, although attention to hematological toxicity should be paid.

Adelstein DJ, Li Y, Adams GL et al (2003) An intergroup phase III comparison of standard radiation therapy and two schedules of concurrent chemoradiotherapy in patients with unresectable squamous cell head and neck cancer. J Clin Oncol 21(1):92–98CrossRefPubMed

Marcial VA, Pajak TF (1985) Radiation therapy alone or in combination with surgery in head and neck cancer. Cancer 55(9 Suppl):2259–2265CrossRefPubMed

Wendt TG, Grabenbauer GG, Rodel CM et al (1998) Simultaneous radiochemotherapy versus radiotherapy alone in advanced head and neck cancer: a randomized multicenter study. J Clin Oncol 16(4):1318–1324CrossRefPubMed

Zakotnik B, Smid L, Budihna M et al (1998) Concomitant radiotherapy with mitomycin C and bleomycin compared with radiotherapy alone in inoperable head and neck cancer: final report. Int J Radiat Oncol Biol Phys 41(5):1121–1127CrossRefPubMed

Bonner JA, Harari PM, Giralt J et al (2006) Radiotherapy plus cetuximab for squamous-cell carcinoma of the head and neck. N Engl J Med 354(6):567–578CrossRefPubMed

Lokich J, Anderson N (1998) Carboplatin versus cisplatin in solid tumors: an analysis of the literature. Ann Oncol 9(1):13–21CrossRefPubMed

Hamauchi S, Yokota T, Onozawa Y et al (2015) Safety and efficacy of concurrent carboplatin plus radiotherapy for locally advanced head and neck cancer patients ineligible for treatment with cisplatin. Jpn J Clin Oncol 45(12):1116–1121PubMed

Kunieda F, Kiyota N, Tahara M et al (2014) Randomized phase II/III trial of post-operative chemoradiotherapy comparing 3-weekly cisplatin with weekly cisplatin in high-risk patients with squamous cell carcinoma of head and neck: Japan Clinical Oncology Group Study (JCOG1008). Jpn J Clin Oncol 44(8):770–774CrossRefPubMed

Tahara M, Kiyota N, Mizusawa J et al (2015) Phase II trial of chemoradiotherapy with S-1 plus cisplatin for unresectable locally advanced head and neck cancer (JCOG0706). Cancer Sci 106(6):726–733CrossRefPubMedPubMedCentral

10.

Fountzilas G, Ciuleanu E, Dafni U et al (2004) Concomitant radiochemotherapy vs radiotherapy alone in patients with head and neck cancer: a Hellenic Cooperative Oncology Group Phase III Study. Med Oncol 21(2):95–107CrossRefPubMed

11.

Chitapanarux I, Lorvidhaya V, Kamnerdsupaphon P et al (2007) Chemoradiation comparing cisplatin versus carboplatin in locally advanced nasopharyngeal cancer: randomised, non-inferiority, open trial. Eur J Cancer 43(9):1399–1406CrossRefPubMed

12.

Posner MR, Hershock DM, Blajman CR et al (2007) Cisplatin and fluorouracil alone or with docetaxel in head and neck cancer. N Engl J Med 357(17):1705–1715CrossRefPubMed

13.

Pignon JP, le Maitre A, Maillard E et al (2009) Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiother Oncol J Eur Soc Ther Radiol Oncol 92(1):4–14CrossRef

14.

Al-Mamgani A, de Ridder M, Navran A et al (2017) The impact of cumulative dose of cisplatin on outcome of patients with head and neck squamous cell carcinoma. Eur Arch Oto-Rhino-Laryngol 274 (10):3757–3765CrossRef

15.

Baxi SS, O’Neill C, Sherman EJ et al (2016) Trends in chemoradiation use in elderly patients with head and neck cancer: changing treatment patterns with cetuximab. Head Neck 38(Suppl 1):E165–E171CrossRefPubMed

16.

Bonner JA, Harari PM, Giralt J et al (2010) Radiotherapy plus cetuximab for locoregionally advanced head and neck cancer: 5-year survival data from a phase 3 randomised trial, and relation between cetuximab-induced rash and survival. Lancet Oncol 11(1):21–28CrossRefPubMed

17.

Giro C, Berger B, Bolke E et al (2009) High rate of severe radiation dermatitis during radiation therapy with concurrent cetuximab in head and neck cancer: results of a survey in EORTC institutes. Radiother Oncol J Eur Soc Ther Radiol Oncol 90(2):166–171CrossRef

18.

Studer G, Brown M, Salgueiro EB et al (2011) Grade 3/4 dermatitis in head and neck cancer patients treated with concurrent cetuximab and IMRT. Int J Radiat Oncol Biol Phys 81(1):110–117CrossRefPubMed

19.

Sakashita T, Homma A, Hatakeyama H et al (2015) 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. Acta Oto-Laryngol 135(8):853–858CrossRef

20.

Zhu G, Lin JC, Kim SB et al (2016) Asian expert recommendation on management of skin and mucosal effects of radiation, with or without the addition of cetuximab or chemotherapy, in treatment of head and neck squamous cell carcinoma. BMC Cancer 16:42CrossRefPubMedPubMedCentral

21.

Yokota T, Onoe T, Ogawa H et al (2015) Distinctive mucositis and feeding-tube dependency in cetuximab plus radiotherapy for head and neck cancer. Jpn J Clin Oncol 45(2):183–188CrossRefPubMed

22.

Kurokawa M, Watanabe Nemoto M, Harada R et al (2015) Initial experience of radiotherapy plus cetuximab for Japanese head and neck cancer patients. J Radiat Res 56(5):849–855CrossRefPubMedPubMedCentral

23.

Jodrell DI, Egorin MJ, Canetta RM et al (1992) Relationships between carboplatin exposure and tumor response and toxicity in patients with ovarian cancer. J Clin Oncol 10(4):520–528CrossRefPubMed

24.

Petrelli F, Coinu A, Riboldi V et al (2014) Concomitant platinum-based chemotherapy or cetuximab with radiotherapy for locally advanced head and neck cancer: a systematic review and meta-analysis of published studies. Oral Oncol 50(11):1041–1048CrossRefPubMed

25.

Magrini SM, Buglione M, Corvo R et al (2016) Cetuximab and radiotherapy versus cisplatin and radiotherapy for locally advanced head and neck cancer: a randomized phase II trial. J Clin Oncol 34(5):427–435CrossRefPubMed

26.

Guan J, Li Q, Zhang Y et al (2016) A meta-analysis comparing cisplatin-based to carboplatin-based chemotherapy in moderate to advanced squamous cell carcinoma of head and neck (SCCHN). Oncotarget 7(6):7110–7119CrossRefPubMedPubMedCentral

Title: Safety and efficacy of concurrent carboplatin or cetuximab plus radiotherapy for locally advanced head and neck cancer patients ineligible for treatment with cisplatin
Authors: Satoshi Hamauchi
Tomoya Yokota
Takatsugu Mizumachi
Yusuke Onozawa
Hirofumi Ogawa
Tsuyoshi Onoe
Tomoyuki Kamijo
Yoshiyuki Iida
Tetsuo Nishimura
Tetsuro Onitsuka
Hirofumi Yasui
Akihiro Homma
Publication date: 01-05-2019
Publisher: Springer Singapore
Keywords: Neutropenia
Radiotherapy
Cetuximab
Published in: International Journal of Clinical Oncology / Issue 5/2019
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-018-01392-9

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