Distinctive mucositis and feeding-tube dependency in cetuximab plus radiotherapy for head and neck cancer
Tomoya Yokota,Tsuyoshi Onoe,Hirofumi Ogawa,Satoshi Hamauchi,Yoshiyuki Iida,Tomoyuki Kamijo,Toshihito Suda,Takashi Yurikusa,Tetsuo Nishimura,Hirofumi Yasui,Tetsuro Onitsuka +10 more
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TLDR
Prophylactic percutaneous endoscopic gastrostomy is recommended because most patients receiving cetuximab and radiotherapy for locally advanced head and neck squamous cell carcinoma have Grade ≥ 3 mucositis with distinctive features.Abstract:
Objective Prophylactic percutaneous endoscopic gastrostomy may be considered before chemoradiotherapy for patients with locally advanced head and neck squamous cell carcinoma, because severe mucositis is a common complication. We evaluated the mucosal findings and necessity of prophylactic percutaneous endoscopic gastrostomy in patients with head and neck squamous cell carcinoma receiving cetuximab and radiotherapy. Methods Fourteen consecutive patients with locally advanced head and neck squamous cell carcinoma receiving cetuximab and radiotherapy were analyzed. Results Patients' backgrounds were as follows: male/female, 8/6; median age, 64.5 years (range, 35-83 years); performance status, 0/1, 9/5. Primary tumor sites included the oropharynx, hypopharynx and larynx in four, seven and three patients, respectively. Patients completed a median of eight cetuximab cycles. All patients received three-dimensional conformal radiotherapy (median dose, 70 Gy). Thirteen patients were treated with elective neck irradiation at the ipsilateral (n = 3) or bilateral (n = 10) nodes. Grade ≥ 3 mucositis/stomatitis (clinical examination) occurred in 85.7% patients (n = 12). The median irradiation dose was 33 Gy at the Grade 3 mucositis onset. Eight patients showed mucositis with distinctive features, a wide range of white-coated lesions with a clear border; hypopharyngeal atresia was observed in two patients. Prophylactic percutaneous endoscopic gastrostomy was performed in 11 patients, and 11 patients (78.6%) actually required nutritional support because of Grade ≥ 3 mucositis/stomatitis (functional/symptomatic). Conclusions Prophylactic percutaneous endoscopic gastrostomy is recommended because most patients receiving cetuximab and radiotherapy for locally advanced head and neck squamous cell carcinoma have Grade ≥ 3 mucositis with distinctive features.read more
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Factors Associated with Severe Late Toxicity After Concurrent Chemoradiation for Locally Advanced Head and Neck Cancer: An RTOG Analysis
Mitchell Machtay,Jennifer Moughan,Andrew Trotti,Adam S. Garden,Randal S. Weber,Jay S. Cooper,Arlene A. Forastiere,K. Kian Ang +7 more
TL;DR: In this paper, the authors evaluated clinical factors that are associated with and might predict severe late toxicity after concurrent chemoradiotherapy (CCRT) for squamous cell carcinoma of the head and neck (SCCHN).
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Metformin as a Radiation Modifier; Implications to Normal Tissue Protection and Tumor Sensitization.
TL;DR: The interesting properties of metformin such as radioprotection, radiomitigation and radiosensitization could make it an interesting adjuvant for clinical radiotherapy, as well as an interesting candidate for mitigation of radiation injury after a radiation disaster.
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Toxicities of systemic agents in squamous cell carcinoma of the head and neck (SCCHN); A new perspective in the era of immunotherapy
Nabil F. Saba,Mayur D. Mody,Elaine S. Tan,Harpaul S. Gill,Alessandra Rinaldo,Robert P. Takes,Primož Strojan,Dana M. Hartl,Dana M. Hartl,Jan B. Vermorken,Missak Haigentz,Alfio Ferlito +11 more
TL;DR: An overview of the toxicity profile of the different systemic agents is provided and a perspective into the future of SCCHN treatment is provided.
Journal ArticleDOI
Association of human papillomavirus and p16 status with mucositis and dysphagia for head and neck cancer patients treated with radiotherapy with or without cetuximab: Assessment from a phase 3 registration trial
James A. Bonner,Jordi Giralt,Paul M. Harari,José Baselga,Sharon A. Spencer,Diana Bell,David Raben,J. Liu,Jeltje Schulten,Kian K. Ang,David I. Rosenthal +10 more
TL;DR: Regardless of p16 status, the addition of cetuximab to RT did not alter the incidence, time to onset, severity, or duration of mucositis and dysphagia and did not impact the frequency of feeding tube use.
Journal ArticleDOI
Asian expert recommendation on management of skin and mucosal effects of radiation, with or without the addition of cetuximab or chemotherapy, in treatment of head and neck squamous cell carcinoma
Guopei Zhu,Jin-Ching Lin,Sung Bae Kim,Jacques Bernier,Jai Prakash Agarwal,Jan B. Vermorken,Dang Huy Quoc Thinh,Hoi-Ching Cheng,Hwan Jung Yun,Imjai Chitapanarux,Prasert Lertsanguansinchai,Vijay Anand Reddy,Xia He +12 more
TL;DR: The literature and clinical experience across Asian countries were collated to compile a practical and implementable set of recommendations for Asian oncologists to manage skin- and mucosa-related toxicities arising from different types of radiation, with or without the addition of cetuximab or chemotherapy.
References
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Journal ArticleDOI
Radiotherapy plus Cetuximab for Squamous-Cell Carcinoma of the Head and Neck
James A. Bonner,Paul M. Harari,Jordi Giralt,Nozar Azarnia,Dong M. Shin,Roger B. Cohen,Christopher U. Jones,Ranjan Sur,David Raben,Jacek Jassem,Roger Ove,Merrill S. Kies,José Baselga,Hagop Youssoufian,Nadia Amellal,Eric K. Rowinsky,Eric K. Rowinsky,K. Kian Ang +17 more
TL;DR: Treatment of locoregionally advanced head and neck cancer with concomitant high-dose radiotherapy plus cetuximab improves locoreGional control and reduces mortality without increasing the common toxic effects associated with radiotherapy to the head andneck.
Journal ArticleDOI
Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer
Arlene A. Forastiere,Helmuth Goepfert,Moshe H. Maor,Thomas F. Pajak,Randal S. Weber,William H. Morrison,Bonnie S. Glisson,Andy Trotti,John A. Ridge,C. Chao,Glen Peters,Ding Jen Lee,Andrea Leaf,John F. Ensley,Jay S. Cooper +14 more
TL;DR: In patients with laryngeal cancer, radiotherapy with concurrent administration of cisplatin is superior to induction chemotherapy followed by radiotherapy or radiotherapy alone for larynGEal preservation and locoregional control.
Journal ArticleDOI
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.
James A. Bonner,Paul M. Harari,Jordi Giralt,Roger B. Cohen,Christopher U. Jones,Ranjan Sur,David Raben,José Baselga,Sharon A. Spencer,Junming Zhu,Hagop Youssoufian,Eric K. Rowinsky,K. Kian Ang +12 more
TL;DR: Overall survival was significantly improved in those who experienced an acneiform rash of at least grade 2 severity compared with patients with no rash or grade 1 rash, confirming cetuximab plus radiotherapy as an important treatment option in this group of patients.
Journal ArticleDOI
Factors Associated With Severe Late Toxicity After Concurrent Chemoradiation for Locally Advanced Head and Neck Cancer: An RTOG Analysis
Mitchell Machtay,Jennifer Moughan,Andrew Trotti,Adam S. Garden,Randal S. Weber,Jay S. Cooper,Arlene A. Forastiere,K. Kian Ang +7 more
TL;DR: Older age, advanced T-stage, and larynx/hypopharynx primary site were strong independent risk factors and neck dissection after CCRT was associated with an increased risk of these complications.
Journal ArticleDOI
Head and neck cancer: changing epidemiology, diagnosis, and treatment.
TL;DR: This review focuses on the goal of organ preservation and postoperative treatment of high-risk patients with the concurrent use of chemotherapy and radiation therapy with the role of inhibitors of the epidermal growth factor receptor in locally advanced and recurrent/metastatic squamous cell cancer of the head and neck.