1038P - Induction chemotherapy with docetaxel, cisplatin and 5-fluorouracil followed by radiotherapy with cetuximab for locally advanced squamous cell carci...

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Anti-Cancer Agents & Biologic Therapy
Head and Neck Cancers
Surgery and/or Radiotherapy of Cancer
Presenter Felix Keil
Authors F. Keil1, E. Selzer2, A. Berghold3, K. Kapp4, A. de Vries5, R. Greil6, S. Reinisch7, W. Anderhuber8, M. Burian9, G.V. Kornek10
  • 1Internal Medicine, Hanusch Krankenhaus, 1140 - Vienna/AT
  • 2University Clinic Of Radiation Therapy And Radiation Biology, Medical University Vienna, Wien/AT
  • 3Institute For Med. Informatics, Statistics And Documentation, Institute for Med. Informatics, statistics and documentation, Graz/AT
  • 4Radiation Therapy - Radiooncology, University Clinic, Graz/AT
  • 5Radiation Therapy, LKH Feldkirch, Feldkirch/AT
  • 6Internal Medicine Iii, University Hospital Salzburg, Salzburg/AT
  • 7Clinical Departement Of General Hnc, Medical University Graz, Graz/AT
  • 8Departement Of Hnc, LKH Leoben, Leoben/AT
  • 9Hnc Departement, Hospital of Barmherzigen Schwestern, Linz/AT
  • 10Oncology, Medical University of Vienna, AT-1090 - Wien/AT

Abstract

Purpose

To determine the efficacy and feasibility of induction chemotherapy with docetaxel, cisplatin and 5-fluorouracil followed by radiotherapy and cetuximab in patients with locally advanced head and neck cancer.

Patients and methods

Forty-nine previously untreated patients (median age: 53 years) with local advanced stage III and IV squamous cell carcinoma of the head and neck received three courses of induction chemotherapy consisting of docetaxel 75 mg/m2 day 1, cisplatin 75 mg/m2 day 1, and infusional 5-Fluorouracil 750 mg/m2/day on days 1-5 followed by radiotherapy plus cetuximab at 250mg/m2/week (after an initial loading dose of 400mg/m2). Patients with an ECOG performance score of 0 or 1 without severe co-morbidities adequate hematopoietic, hepatic, and renal functions were eligible.

Results

After completion of induction chemotherapy 44 of 49 patients received radiotherapy plus cetuximab. In 45 patients ICT was delivered without delay or dose reduction and 38 patients received RT at the full dose. Three months after therapy completion tumor response was observed in 33 patients and after 2 years, 25 patients were in complete remission. Although treatment was accompanied with a rate of grate 3 and 4 toxicity of 30% during induction chemotherapy and up to 68% during radiotherapy with cetuximab, our treatment seems feasible. Toxicities resolved within 3 months after end of treatment and only two patients became dependent on gastric feeding tubes after two years, compared to 21 patients during treatment. We lost one patient because of treatment related toxicity and 73% of the 49 included patients finished treatment without dose reduction or delay of treatment. 2-year progression-free survival rate was 59% and 2-year overall survival rate was 63%, respectively.

Conclusion

Concurrent radiotherapy plus cetuximab after three courses of induction chemotherapy was feasible and associated with promising complete remission, progression-free and overall survival rates. Further optimization of dose and sequence is warranted.

Disclosure

All authors have declared no conflicts of interest.