The efficacy of combined treatment with cetuximab (erbitux) and radiation therapy in patients with head and neck cancer.
Squamous cell carcinoma of the head and neck (SCCHN) region is among the most frequent human tumors due to the alcohol and tobacco abuse. Its management has evolved gradually from surgery as the mainstay of therapy to irradiation as the principal treatment. When radiation therapy is combined with chemotherapy, additional benefit is obtained. The value of chemoradiotherapy (CRT) is, however, counterbalanced by increased and often prohibitive toxicity, particularly among patients with coexisting medical conditions and decreased performance status. A member of the ErbB family of receptor tyrosine kinases known as the epidermal growth factor receptor (EGFR) is abnormally activated in epithelial cancers, including head and neck cancers. Overexpression of EGFR is a feature associated with poor clinical outcome. It is observed that radiation increases the expression of EGFR in cancer cells and the blockade of EGFR signaling sensitizes cells to the effects of radiation. The cytotoxic effects of radiation therapy in squamous cell carcinoma could be enhanced by cetuximab (erbitux), a monoclonal antibody against the ligand-binding domain of EGFR. The major studies that focus on the efficacy of adding cetuximab to radiotherapy in the treatment of patients with head and neck cancer and its impact in quality of life are reviewed in this study.
University of Athens, Medical School, 2nd Department of Radiology, Radiation Therapy Unit, "Attikon" University Hospital, Athens, Greece. gkoyokoyrakis@yahoo.gr
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G
Koukourakis
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V
Kouloulias
M
M
Koukourakis
J
J
Kouvaris
G
G
Zacharias
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A
Gouliamos
D000818:Animals; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000532:radiotherapy*; D000068818:Cetuximab; D017024:Chemotherapy, Adjuvant; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000201:enzymology / Q000532:radiotherapy*; D006801:Humans; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; C512478:EGFR protein, human; D066246:ErbB Receptors; D000068818:Cetuximab