Efficacy and feasibility of induction chemotherapy and radiotherapy plus cetuximab in head and neck cancer.
BACKGROUND
To determine the potential activity and tolerability of sequential treatment in head and neck cancer, we conducted a phase II trial based on induction chemotherapy of two cycles of taxotere, cisplatin and 5-fluorouracil followed by radiotherapy plus weekly cetuximab.


METHODS
Thirty-six patients with stage III or IV squamous cell carcinoma of the oral cavity, larynx, oropharynx and hypopharynx were treated and evaluated for response and acute toxicity.


RESULTS
Eighty-one percent of patients had stage IV disease and 42% had hypopharyngeal and oral cavity primaries. The overall response rate was 81.8%, with 60.6% complete response and 33.3% partial response. Severe toxicities were febrile neutropenia (6%) during induction chemotherapy and dermatitis (48%), mucositis (33%) and dysphagia (12%) during the concurrent phase.


CONCLUSIONS
Our protocol proved to be feasible, effective and well tolerated. This sequential strategy should be further investigated.
Department of Medical and Surgical Sciences, Radiation Oncology Unit, University of Torino, San Giovanni Battista Hospital, Torino, Italy. mrampino@molinette.piemonte.it
M
M
Rampino
A
A
Bacigalupo
E
E
Russi
M
M
Schena
L
L
Lastrucci
C
C
Iotti
A
A
Reali
A
A
Musu
V
V
Balcet
C
C
Piva
S
S
Bustreo
F
F
Munoz
R
R
Ragona
R
R
Corvò
U
U
Ricardi
D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001952:Bridged-Ring Compounds / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D000068818:Cetuximab; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D005240:Feasibility Studies; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006801:Humans; D060828:Induction Chemotherapy; D008297:Male; D020714:Maximum Tolerated Dose; D008875:Middle Aged; D009367:Neoplasm Staging; D012074:Remission Induction; D015996:Survival Rate; D043823:Taxoids / Q000008:administration & dosage; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D001952:Bridged-Ring Compounds; D043823:Taxoids; C080625:taxane; D000068818:Cetuximab; D002945:Cisplatin; D005472:Fluorouracil