PMID- 25072020
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20140729
LR  - 20211021
IS  - 2234-943X (Print)
IS  - 2234-943X (Electronic)
IS  - 2234-943X (Linking)
VI  - 4
DP  - 2014
TI  - Concurrent radiotherapy with Carboplatin and cetuximab for the treatment of 
      medically compromised patients with locoregionally advanced head and neck 
      squamous cell carcinoma.
PG  - 165
LID - 10.3389/fonc.2014.00165 [doi]
LID - 165
AB  - BACKGROUND: Cetuximab (Cx) + radiation therapy (RT) is well-tolerated and has 
      improved survival in patients (pts) with locoregionally advanced head and neck 
      squamous cell carcinomas (LA-HNSCC). However, its efficacy when compared to 
      HD-DDP + RT has been questioned. At our institution, low-dose weekly carboplatin 
      is added to Cx + RT for patients unsuitable for HD-DDP. METHODS: We reviewed 
      records of 16 patients with LA-HNSCC treated with definitive 
      Cx + carboplatin + RT at the University of Miami from 2007 to 2011. Median 
      follow-up was 24 months (range: 1-69 months). RESULTS: Median age: 71.5 years 
      (range: 57-90 years); 15 male, 1 female. ECOG PS 0 = 15, 1 = 1. TNM staging was: 
      T 1 = 1, T 2 = 5, T 3 = 8, T 4 = 2; N stage: N 0 = 8, N 1 = 5, N 2a = 2, N 
      2b = 1. All patients received weekly carboplatin (AUC 1.5-2), Cx given 
      conventionally and daily conventionally fractionated RT. Median total weeks of 
      concurrent systemic therapy = 7 (range: 3-8 weeks). RT was delivered to a median 
      total dose of 70 Gy (range 30-74 Gy). Of the 15 evaluable patients, there were: 
      12 CR, 2 PR, and 1 PD. There were three local in-field failures, two regional 
      failures, and three distant failures. At last follow-up, 8/15 patients remained 
      with NED. Three-year locoregional recurrence was 28.3% (95% CI: 7.7-53.9%). Mean 
      percentage of weight loss was 14% (range: 6-26%). Two patients required systemic 
      therapy dose reduction. Three patients experienced a treatment delay and three 
      did not finish RT as planned including a patient who received only 30 Gy due to 
      death secondary to MI during treatment. CONCLUSION: In this small retrospective 
      series, carboplatin/Cx/RT was well-tolerated and efficacious in patients 
      unsuitable for HD-DDP having LA-HNSCC. Acute toxicities were similar to Cx + RT, 
      likely due to the non-overlapping toxicity profiles of the two systemic agents. 
      We hypothesize that the addition of a well-tolerated cytotoxic chemotherapy agent 
      may improve the therapeutic ratio of Cx + RT in patients who are poor candidates 
      for more aggressive therapies and warrants evaluation in a prospective manner.
FAU - Saigal, Kunal
AU  - Saigal K
AD  - Department of Radiation Oncology, University of Miami School of Medicine , Miami, 
      FL , USA.
FAU - Santos, Edgardo S
AU  - Santos ES
AD  - Division of Medical Oncology, Lynn Cancer Institute , Boca Raton, FL , USA.
FAU - Tolba, Khaled
AU  - Tolba K
AD  - Division of Medical Oncology, University of Miami School of Medicine , Miami, FL 
      , USA.
FAU - Kwon, Deukwoo
AU  - Kwon D
AD  - Department of Epidemiology and Biostatistics, University of Miami School of 
      Medicine , Miami, FL , USA.
FAU - Elsayyad, Nagy
AU  - Elsayyad N
AD  - Department of Radiation Oncology, University of Miami School of Medicine , Miami, 
      FL , USA.
FAU - Abramowitz, Matthew C
AU  - Abramowitz MC
AD  - Department of Radiation Oncology, University of Miami School of Medicine , Miami, 
      FL , USA.
FAU - Mandalia, Amar
AU  - Mandalia A
AD  - University of Miami School of Medicine , Miami, FL , USA.
FAU - Samuels, Michael Andrew
AU  - Samuels MA
AD  - Department of Radiation Oncology, University of Miami School of Medicine , Miami, 
      FL , USA.
LA  - eng
PT  - Journal Article
DEP - 20140630
PL  - Switzerland
TA  - Front Oncol
JT  - Frontiers in oncology
JID - 101568867
PMC - PMC4074875
OTO - NOTNLM
OT  - carboplatin
OT  - cetuximab
OT  - head
OT  - neck
OT  - radiation
OT  - squamous cell carcinoma
EDAT- 2014/07/30 06:00
MHDA- 2014/07/30 06:01
PMCR- 2014/01/01
CRDT- 2014/07/30 06:00
PHST- 2013/09/04 00:00 [received]
PHST- 2014/06/10 00:00 [accepted]
PHST- 2014/07/30 06:00 [entrez]
PHST- 2014/07/30 06:00 [pubmed]
PHST- 2014/07/30 06:01 [medline]
PHST- 2014/01/01 00:00 [pmc-release]
AID - 10.3389/fonc.2014.00165 [doi]
PST - epublish
SO  - Front Oncol. 2014 Jun 30;4:165. doi: 10.3389/fonc.2014.00165. eCollection 2014.