title: Retrospective evaluation of concomitant cetuximab and radiotherapy tolerance for locoregional advanced head and neck squamous cell carcinoma treatment in patients unfit for platinum-based chemotherapy.
abstract: Radiotherapy associated with cetuximab (Cet-RT) is an alternative treatment to platinum-based chemoradiotherapy in locally advanced head and neck carcinoma (LAHNC). Reviews suggest that the use of cetuximab is associated with poorer tolerance in patients unfit for chemotherapy than in pivotal trial. We retrospectively studied patients first treated by Cet-RT for LAHNC presenting contraindications to chemoradiotherapy. Objectives were treated population description, acute tolerance, progression-free survival (PFS), overall survival (OS), and 3-month clinical response. Eighty-eight patients were included. Treatment was completed without delay for 43 patients. Grade 3-4 acute toxicity was described in 44.3%: mucositis (n = 20), radiodermatitis (n = 25) folliculitis (n = 10), and anaphylaxis (n = 6). Fourteen patients died during treatment. Median PFS and OS were 6.3 and 18.7 months, respectively. We confirm that Cet-RT tolerance in unfit patients is poorer than that in trials. Survival data illustrate patients' frailty and suggest that balanced use of Cet-RT is required in this population.
authors.affiliation: Medical Oncology Department, Centre François Baclesse, Av général Harris, 14000, Caen, France. audrey.rambeau@gmail.com.
authors.forename: Audrey
authors.initials: A
authors.lastname: Rambeau
authors.affiliation: Medical Oncology Department, Centre François Baclesse, Av général Harris, 14000, Caen, France.
authors.forename: Radj
authors.initials: R
authors.lastname: Gervais
authors.affiliation: Department of Head and Neck Surgery, Centre François Baclesse, 14000, Caen, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: De Raucourt
authors.affiliation: Department of Head and Neck Surgery, Centre Hospitalier Universitaire, 14000, Caen, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Babin
authors.affiliation: Clinical Research unit, Centre François Baclesse, 14000, Caen, France.
authors.forename: Audrey Emmanuelle
authors.initials: AE
authors.lastname: Dugué
authors.affiliation: Department of Radiotherapy, Head and Neck Unit, Centre François Baclesse, 14000, Caen, France.
authors.forename: Carmen
authors.initials: C
authors.lastname: Florescu
authors.affiliation: Department of Head and Neck Surgery, Centre François Baclesse, 14000, Caen, France.
authors.forename: David
authors.initials: D
authors.lastname: Blanchard
authors.affiliation: Department of Radiotherapy, Head and Neck Unit, Centre François Baclesse, 14000, Caen, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Gery
mesh_terms: D000328:Adult; D000368:Aged; D000074322:Antineoplastic Agents, Immunological / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy; D000068818:Cetuximab / Q000008:administration & dosage / Q000009:adverse effects; D059248:Chemoradiotherapy / Q000009:adverse effects / Q000379:methods; D064420:Drug-Related Side Effects and Adverse Reactions / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005602:France; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D018579:Patient Selection; D011358:Product Surveillance, Postmarketing; D011855:Radiodermatitis / Q000175:diagnosis / Q000209:etiology; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D016019:Survival Analysis
chemical_list: D000074322:Antineoplastic Agents, Immunological; D000068818:Cetuximab