IMRT reirradiation with concurrent cetuximab immunotherapy in recurrent head and neck cancer

Felix Zwicker, Falk Roeder, Christian Thieke, Carmen Timke, Marc W. Münter, Peter Huber, Jürgen Debus

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Purpose: : In this retrospective investigation, the outcome and toxicity after reirradiation with concurrent cetuximab immunotherapy of recurrent head and neck cancer (HNC) in patients who had contraindications to platinum-based chemotherapy were analyzed. Materials and Methods: : Ten patients with locally advanced recurrent HNC were retrospectively evaluated. In 9 cases, histology was squamous cell carcinoma, in one case adenoid cystic carcinoma. External beam radiotherapy was part of the initial treatment in all cases. Reirradiation was carried out using step-and-shoot intensity-modulated radiotherapy (IMRT) with a median dose of 50.4 Gy. Cetuximab was applied as loading dose (400 mg/m 2) 1 week prior to reirradiation and then weekly concurrently with radiotherapy (250 mg/m2). Results: : The median overall survival time after initiation of reirradiation was 7 months; the 1-year overall survival (OS) rate was 40%. Local failure was found in 3 patients, resulting in a 1-year local control (LC) rate of 61%. The 1-year locoregional control (LRC) rate was 44%, while the 1-year distant metastasis-free survival (DMFS) was 75%. Acute hematological toxicity was not observed in the group. Severe acute toxicity included one fatal infield arterial bleeding and one flap necrosis. Severe late toxicities were noted in 2 patients: fibrosis of the temporomandibular joint in 1 patient and stenosis of the cervical esophagus in another. Conclusions: : IMRT reirradiation with concurrent cetuximab immunotherapy in recurrent HNC is feasible with acceptable acute toxicity. Further investigations are necessary to determine the clinical role of this therapy concept.

Original languageEnglish (US)
Pages (from-to)32-38
Number of pages7
JournalStrahlentherapie und Onkologie
Volume187
Issue number1
DOIs
StatePublished - Jan 1 2011

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Intensity-Modulated Radiotherapy
Head and Neck Neoplasms
Immunotherapy
Radiotherapy
Adenoid Cystic Carcinoma
Survival
Temporomandibular Joint
Platinum
Esophagus
Squamous Cell Carcinoma
Histology
Pathologic Constriction
Fibrosis
Necrosis
Survival Rate
Re-Irradiation
Cetuximab
Hemorrhage
Neoplasm Metastasis
Drug Therapy

Keywords

  • Cetuximab
  • IMRT
  • Recurrent head and neck cancer
  • Reirradiation
  • Toxicity

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Oncology

Cite this

IMRT reirradiation with concurrent cetuximab immunotherapy in recurrent head and neck cancer. / Zwicker, Felix; Roeder, Falk; Thieke, Christian; Timke, Carmen; Münter, Marc W.; Huber, Peter; Debus, Jürgen.

In: Strahlentherapie und Onkologie, Vol. 187, No. 1, 01.01.2011, p. 32-38.

Research output: Contribution to journalArticle

Zwicker, Felix ; Roeder, Falk ; Thieke, Christian ; Timke, Carmen ; Münter, Marc W. ; Huber, Peter ; Debus, Jürgen. / IMRT reirradiation with concurrent cetuximab immunotherapy in recurrent head and neck cancer. In: Strahlentherapie und Onkologie. 2011 ; Vol. 187, No. 1. pp. 32-38.
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