[an error occurred while processing this directive] | [an error occurred while processing this directive]
Multicenter safety study on cetuximab combined with intensity modulated radiotherapy and concurrent chemotherapy of cisplatin in locoregionally advanced nasopharyngeal carcinoma
CHEN Chun-yan*, ZHAO Chong, GAO Li, LANG Jin-yi, PAN Jian-ji, HU Chao-su, JIN Feng, WANG Ren-sheng, XIE Cong-hua, LIN Tong-yu, LU Tai-xiang
*Departments of Radiation Oncology, Cancer Center, Sun Yat-sen University; State Key Laboratory of Oncology in South China; Guangzhou 510060, China Corresponding author:LU Tai-xiang, Email:lutx@sysucc.org.cn
Abstract Objective To evaluate the safety of cetuximab combined with intensity-modulated radiotherapy (IMRT) plus concurrent cisplatin chemotherapy in locoregionally advanced nasopharyngeal carcinoma (NPC) in a Chinese multicenter clinical study. Methods From July 2008 to April 2009, 100 Patients with primary stage Ⅲ－Ⅳb non-keratinizing NPC were enrolled. The planned dose of IMRT to gross tumor volume and positive cervical lymph nodes was 66.0－75.9 Gy and 60－70 Gy in 30－33 fractions. Cisplatin (80 mg/m2, q3 week (w)) and cetuximab (400 mg/m2 one w before radiation, and then 250 mg/m2 per w) were given concurrently. The adverse events (AEs) were graded according to common terminology criteria for adverse events v3.0. Results The compliance of the entire group of patient was satisfactory. Actual median dose to gross tumor volume was 69.96 Gy, and the median dose to positive cervical lymph nodes was 68 Gy. Median dose of cisplatin was 133 mg, median first-dose of cetuximab was 690 mg, and median weekly dose was 410 mg. AEs were well tolerated and manageable, mainly consisting of acneiform skin eruptions, dermatitis and mucositis. Grade 4 mucositis was observed in 2% of the patients and no other grade 4 AEs were observed. Conclusions The combined treatment modality of IMRT+concurrent chemotherapy+cetuximab in loco-regionally advanced NPC is well tolerated.
CHEN Chun-yan*,ZHAO Chong,GAO Li et al. Multicenter safety study on cetuximab combined with intensity modulated radiotherapy and concurrent chemotherapy of cisplatin in locoregionally advanced nasopharyngeal carcinoma[J]. Chinese Journal of Radiation Oncology, 2012, 21(3): 201-204.
CHEN Chun-yan*,ZHAO Chong,GAO Li et al. Multicenter safety study on cetuximab combined with intensity modulated radiotherapy and concurrent chemotherapy of cisplatin in locoregionally advanced nasopharyngeal carcinoma[J]. Chinese Journal of Radiation Oncology, 2012, 21(3): 201-204.
[1] Lee AW, Poon YF, Foo W, et al. Retrospective analysis of 5037 patients with nasopharyngeal carcinoma treated during 1976—1985:overall survival and patterns of failure. Int J Radiat Oncol Biol Phys,1992,23:261-270. [2] Langendijk JA, Leemans CR, Buter J, et al. The additional value of chemotherapy to radiotherapy in locally advanced nasopharyngeal carcinoma:a meta-analysis of the published literature. J Clin Oncol,2004,22:4604-4612. [3] Xiao WW, Huang SM, Han F, et al. Local control, survival, and late toxicities of locally advanced nasopharyngeal carcinoma treated by simultaneous modulated accelerated radiotherapy combined with cisplatin concurrent chemotherapy:long-term results of a phase 2 study. Cancer,2011,117:1874-1883. [4] Bonner JA, Harari PM, Giralt J, et al. Radiotherapy plus cetuximab for squamous cell carcinoma of the head and neck. N Engl J Med,2006,354:567-578. [5] Chan AT, Hsu MM, Goh BC, et al. Multicenter, phase Ⅱ study of cetuximab in combination with carboplatin in patients with recurrent or metastatic nasopharyngeal carcinoma. J Clin Oncol,2005,23:3568-3576. [6] Walsh L, Gillham C, Dunne M, et al. Toxicity of cetuximab versus cisplatin concurrent with radiotherapy in locally advanced head and neck squamous cell cancer (LAHNSCC). Radiother Oncol,2011,98:38-41. [7] Lee AW, Sze WM, Au JS, et al. Treatment results for nasopharyngeal carcinoma in the modern era:the Hong Kong experience. Int J Radia Biol Phys,2005,61:1107-1116. [8] Lin JC, Jan JS, Hsu CY, et al. Phase Ⅲ study of concurrent chemoradiotherapy versus radiotherapy alone for advanced nasopharyngeal carcinoma:positive effect on overall and progression-free survival. J Clin Oncol,2003,21:631-637. [9] Chan AT, Leung SF, Ngan RK, et al. Overall survival after concurrent cisplatin-radiotherapy compared with radiotherapy alone in locoregionally advanced nasopharyngeal carcinoma. J Natl Cancer Inst,2005,97:536-539. [10] Zhang L, Zhao C, Ghimire B, et al. The role of concurrent chemoradiotherapy in the treatment of locoregionally advanced nasopharyngeal carcinoma among endemic population:a meta-analysis of the phase Ⅲ randomized trials. BMC Cancer,2010,10:558. [11] Ng WT, Lee MC, Hung WM, et al. Clinical outcomes and patterns of failure after intensity-modulated radiotherapy for nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys,2011,In press. [12] Bonner JA, Harari PM, Giralt J, et al. Radiotherapy plus cetuximab for locoregionally advanced head and neck cancer:5-year survival data from a phase 3 randomised trial, and relation between cetuximab-induced rash and survival. Lancet Oncol,2010,11:21-28. [13] Jensen AD, Bergmann ZP, Garcia-Huttenlocher H, et al. Cetuximab and radiation for primary and recurrent squamous cell carcinoma of the head and neck (SCCHN) in the elderly and multi-morbid patient:a single-centre experience. Head Neck Oncol,2010,2:34. [14] Curran D, Giralt J, Harari PM, et al. Quality of life in head and neck cancer patients after treatment with high-dose radiotherapy alone or in combination with cetuximab. J Clin Oncol,2007,25:2191-2197. [15] Budach W, Blke E. Homey B:severe cutaneous reaction during radiation therapy with concurrent cetuximab. N Engl J Med,2007,357:514-515. [16] Koutcher L, Sherman E, Fury M, et al. Concurrent cisplatin and radiation versus cetuximab and radiation for locally advanced head-and-neck cancer. Int J Radiat Oncol Biol Phys,2011,In press. [17] Koukourakis MI, Tsoutsou PG, Karpouzis A, et al. Radiochemotherapy with cetuximab, cisplatin, and amifostine for locally advanced head and neck cancer:a feasibility study. Int J Radiat Oncol Biol Phys,2010,77:9-15.
2012, Vol. 21 
