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
Epidermal growth factor receptor expression on oral mucosa dysplastic epithelia and squamous cell carcinomas
Maria E. Christensen,Marianne Hamilton Therkildsen,Bente Langvad Hansen,H. Albeck,Georg Nørgaard Hansen,Poul Bretlau +5 more
TL;DR: The results of the present investigation confirm the presence of the EGF receptor on undifferentiated cells, with the extent of the staining reaction on oral squamous cell carcinomas varying inversely with cellular differentiation.
Journal ArticleDOI
Radiation treatment interruptions greater than one week and low hemoglobin levels (12 g/dL) are predictors of local regional failure after definitive concurrent chemotherapy and intensity-modulated radiation therapy for squamous cell carcinoma of the head and neck.
Susan A. McCloskey,Wainwright Jaggernauth,Nestor R. Rigual,Wesley L. Hicks,Saurin R. Popat,Maureen Sullivan,Terry Mashtare,Mohamed K. Khan,Thom R. Loree,Anurag K. Singh +9 more
TL;DR: Overall radiation treatment time and pretreatment hemoglobin level were significant predictors for loco-regional failure after definitive concurrent chemotherapy and IMRT for SCCHN.
Journal ArticleDOI
Prospective randomized trial comparing the direct method using a 24 Fr bumper-button-type device with the pull method for percutaneous endoscopic gastrostomy.
TL;DR: The direct method using a 24 Fr bumper-button-type device was associated with reduced peristomal infections in the early phase and reduced catheter changes compared with a 20 Fr catheter placed using the standard pull method.
Journal ArticleDOI
Longitudinal oncology registry of head and neck carcinoma (LORHAN)
Stuart J. Wong,Paul M. Harari,Adam S. Garden,Marc Schwartz,Lisa A. Bellm,Amy Y. Chen,Walter J. Curran,Barbara A. Murphy,K. Kian Ang +8 more
TL;DR: A study was undertaken to examine the patterns of systemic therapy use in conjunction with radiation therapy for patients with locally advanced head and neck squamous cell cancer.
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Percutaneous feeding tubes in patients with head and neck cancer: rethinking prophylactic placement for patients undergoing chemoradiation.
Joshua D. Lawson,Jennifer Gaultney,Nabil F. Saba,William Grist,Lawrence W. Davis,Peter A.S. Johnstone +5 more
TL;DR: Feeding tubes are required for more than 2 months after combined modality treatment of head and neck cancer, but toxicities are not trivial: more than 10% require replacement and more than 8% of patients develop infection at the insertion site.