Comparison between weekly cisplatin-enhanced radiotherapy and cetuximab-enhanced radiotherapy in locally advanced head and neck cancer: first retrospective study in Asian population.
OBJECTIVE
To present a direct comparison between chemotherapy-enhanced radiotherapy (CERT) and biotherapy-enhanced radiotherapy (BERT) in locally advanced head and neck cancer.


METHODS
It is a retrospective analysis of 53 patients with locally advanced head and neck cancer treated from August 2006 to December 2008. For CERT, patients received weekly cisplatin (40 mg/m2) and for BERT, a loading dose of 400 mg/m2of cetuximab given one week prior to radiotherapy followed by 250 mg/m2given weekly along with radiotherapy. Disease-free survival (DFS) and overall survival (OS) were computed with Kaplan-Meier curve with log-rank test for comparison between the two groups. Multivariate Cox proportional hazards regression analysis was performed to estimate the impact of known relevant prognostic factors on DFS and OS.


RESULTS
The median DFS was significantly better with CERT than BERT group (50.82 vs 11.66 months; P = 0.031). The 3 years DFS was significantly higher in CERT group than in BERT group (60.0% vs 14.3%; P = 0.022). The median OS was significantly better with CERT than BERT group (53.61 vs 32.55 months; P = 0.044). The 3 years OS was also significantly higher in CERT group than in BERT group (74.0% vs 42.1%; P = 0.032). There were no significant differences in acute toxicities of all grade and grade ≥3 between the two groups. The compliance to treatment and assisted feeding dependency for more than 6 months duration were also not significantly different.


CONCLUSIONS
CERT is associated with better outcome with no significantly increased acute toxicities compared to BERT.
Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
Sheh
S
Rawat
Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
Parveen
P
Ahlawat
Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
Anjali
A
Kakria
Department of Medical Oncology, Max Super Specialty Hospital, Shalimar Bagh, New Delhi, India.
Gaurav
G
Kumar
Department of Medical Oncology, Max Super Specialty Hospital, Shalimar Bagh, New Delhi, India.
Ranga Rao
RR
Rangaraju
Department of Radiation Oncology, Fortis Hospital, Mohali, Punjab, India.
Abhishek
A
Puri
Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
Manoj
M
Pal
Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
Deepika
D
Chauhan
Department of Radiotherapy, All India Institute of Medical Sciences, New Delhi, India.
Bharti
B
Devnani
Department of Radiation Oncology, Kokilaben Dhirubhai Ambani Hospital & Medical Research Institute, Mumbai, Maharashtra, India.
Pranav
P
Chadha
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D044466:Asian People; D000068818:Cetuximab / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D059248:Chemoradiotherapy / Q000379:methods*; D002945:Cisplatin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D000068818:Cetuximab; D002945:Cisplatin
cetuximab; cisplatin; head and neck cancer