Phase II/III randomized study of hyperfractionated radiotherapy with concomitant cetuximab versus concomitant chemotherapy in advanced nonmetastatic head and neck cancer: Preliminary report
| Autor: | Khalid Al Saleh, Jitendra Shete, H.S. Hooda, Reham Safwat, A. Bedair, Amany Al Basmy |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Oncology
Cancer Research medicine.medical_specialty Chemotherapy Cetuximab business.industry medicine.medical_treatment Head and neck cancer Hyperfractionated radiation therapy medicine.disease Hyperfractionated radiotherapy law.invention Randomized controlled trial law Preliminary report Internal medicine Concomitant medicine business medicine.drug |
| Zdroj: | Journal of Clinical Oncology. 30:e16002-e16002 |
| ISSN: | 1527-7755 0732-183X |
| DOI: | 10.1200/jco.2012.30.15_suppl.e16002 |
| Popis: | e16002 Background: This is a randomized study to compare the use of cetuximab versus platinum based chemotherapy with concurrent hyperfractionated radiation therapy (HRT). Acute and late morbidity, locoregional control (LC) and disease free survival (DFS) were set as primary end points, while overall survival (OS) was set as secondary end point. Methods: Between December 2009 and May 2011, 24 patients were randomly assigned to HRT consisting of 120 cGy twice daily, for a total of 69.6 Gys in 58 fractions over 6 weeks, plus either cisplatin chemotherapy at weeks 1, 4, 6 (Arm A: 14 patients) or weekly cetuximab (Arm B: 10 patients). The overall radiation dose was the same for the two groups. The median follow up time of the whole group was 14.07 months (IQR: 5.8- 25.0 ms). Results: Overall treatment time was 72 days in arm A and 63 days in arm B (p= 0.64). Grade 3 skin toxicity was experienced in 42.9% of patients in arm A and 9.1% in arm B (p= 0.09). Grade 3 mucositis was 64.3% in arm A and 45.5% in arm B (p= 0.43). Hematologic toxicity of G3-4 occurred in 21.4% and 18% of the cases respectively (p= 0.06). The mean percent of weight loss was (13 % +/- 0.1%) in group A, and (10.75 % +/- 0.1%) in group B respectively (p=0.56). Complete response was observed in 12 (85.7%) and 100% of patients of arm A and B respectively. Partial response was achieved in the remaining 2 (14.2%) patients in arm A. Loco-regional recurrence occurred in 2 (14.2%) of the patients in arm A after partial response, and one of them died eventually due to progressive disease. Two patients developed distant metastasis, one patient in arm A and another one in arm B. As the sample size was small and events were limited, survival analysis could not be computed at this stage of the study Conclusions: Hyperfractionated radiotherapy and concurrent cetuximab seems to have less side effects compared to concurrent platinum. There's a trend of less skin, mucosal and haematological toxicity with cetuximab that might become significant as the number of patients increase. We will be able to evaluate the outcomes of the patients regarding LC, DFS and OS within 2 years. |
| Databáze: | OpenAIRE |
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