• Head & Neck Cancers
• Radiology
• Radiation Therapy
• Oncology Clinical Trials

• Oncology
• Head & Neck Cancers
• Radiology
• Radiation Therapy
• Oncology Clinical Trials

Concurrent reirradiation and combined chemotherapy treatment were tolerable in patients with recurrent head and neck squamous cell carcinoma (HNSCC). Min Yao, MD, PhD, University Hospitals Case Medical Center, Cleveland, Ohio, USA, presented data from a multicenter prospective phase 2 study.

Due to the poor prognosis of recurrent HNSCC, there is an imperative to identify a safe and tolerable therapy course. Despite the prevalence of combined radiotherapy and chemotherapy, an optimal therapeutic regimen has not been elucidated. This study assessed limited-volume continuous-course intensity-modulated reirradiation (IMRT) and weekly cetuximab with platinum-based chemotherapy.

A total of 46 patients (26% female) with recurrent HNSCC and unresectable tumors or positive margins after surgery participated in this trial. All patients had an Eastern Cooperative Oncology Group performance status of 0 to 1 and previously received radiotherapy for > 6 months without the combination of drugs used in this study.

Over the course of a 7-week period, patients received daily continuous-course IMRT at a dose of 60 to 66 Gy in 30 fractions to the gross tumor volume. During week 1, a loading dose of 400 mg/m² of cetuximab was administered. During weeks 2 to 7, concurrent cetuximab (250 mg/m²) and cisplatinum (30 mg/m²) were applied.

The 1-year overall survival rate was 60%, and at the final follow-up, 27 patients were alive. The 1-year disease-free survival rate was 38%. This therapeutic regimen had a range of grade 1 to 4 acute toxicities, with the most common higher-grade toxicities being lymphopenia, dysphagia, radiation-site dermatitis, mucositis, and anorexia. A single patient discontinued treatment.

Some patients experienced local toxicities 90 days after reirradiation, and the highest-grade complication was associated with dysphagia (grade 3). The most common late toxicities were dysphagia, xerostomia, edema, mucositis, fibrosis, and trismus.

The authors determined that patients with recurrent HNSCC could complete a concurrent reirradiation and chemotherapy trial. Further examination of treatment optimization for this disease stage is necessary.

• © 2014 MD Conference Express®