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01.08.2015 | Original Article

Re-irradiation with cetuximab or cisplatin-based chemotherapy for recurrent squamous cell carcinoma of the head and neck

verfasst von: Nicolas Dornoff, Christian Weiß, M.D., Franz Rödel, Ph.D., Jens Wagenblast, M.D., Shahram Ghanaati, M.D., Nateghian Atefeh, Claus Rödel, M.D., Panagiotis Balermpas, M.D.

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 8/2015

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Abstract

Purpose

Locoregional recurrence remains the main pattern of failure after primary combined modality treatment of squamous cell carcinoma of the head and neck (SCCHN). We compared the efficacy and toxicity of either cisplatin or cetuximab in combination with re-irradiation (ReRT) for recurrent unresectable SCCHN. Various clinicopathological factors were investigated to establish a prognostic score.

Patients and methods

Between 2007 and 2014, 66 patients with recurrent SCCHN originating in a previously irradiated area received cetuximab (n = 33) or cisplatin-based chemotherapy (n = 33) concomitant with ReRT. Toxicity was evaluated weekly and at every follow-up visit. Physical examination, endoscopy, CT or MRI scans were used to evaluate response and disease control.

Results

With a mean follow-up of 18.3 months, the 1-year overall survival (OS) rates for Re-RT with cetuximab and cisplatin-based chemotherapy were 44.4 and 45.5 % (p = 0.352), respectively. At 1 year, local control rates (LCR) were 46.4 and 54.2 % (p = 0.625), freedom from metastases (FFM) rates 73.6 and 81 % (p = 0.842), respectively. Haematological toxicity ≥ grade 3 occurred more often in the cisplatin group (p < 0.001), pain ≥ grade 3 was increased in the cetuximab group (p = 0.034). A physiological haemoglobin level and a longer interval between primary RT and ReRT, proved to be significant prognostic factors for OS (multivariate: p = 0.003, p = 0.002, respectively). Site of the recurrence and gross target volume (GTV) did not show a significant impact on OS in multivariate analysis (p = 0.160, p = 0.167, respectively). A prognostic-score (1–4 points) based on these four variables identified significantly different subgroups: 1-year OS for 0/1/2/3/4 prognostic points: 10, 38, 76, 80 and 100 %, respectively (p < 0.001).

Conclusion

Both cetuximab- and cisplatin-based ReRT of SCCHN recurrences are feasible and effective treatment options with comparable results in terms of tumour control and survival. Acute adverse events may differ slightly. Our prognostic score could help to identify appropriate patients for ReRT and stratify patients within future clinical trials.

Bernier J, Domenge C, Ozsahin M et al (2004) Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med 350:1945–1952PubMedCrossRef

Forastiere AA, Zhang Q, Weber RS et al (2013) Long-term results of RTOG 91-11: a comparison of three nonsurgical treatment strategies to preserve the larynx in patients with locally advanced larynx cancer. J Clin Oncol 31:845–852PubMedCentralPubMedCrossRef

Pignon JP, le Maitre A, Maillard E et al (2009) Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiother Oncol 92:4–14PubMedCrossRef

Bonner JA, Harari PM, Giralt J et al (2010) 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. Lancet Oncol 11:21–28PubMedCrossRef

Brockstein B, Haraf DJ, Rademaker AW et al (2004) Patterns of failure, prognostic factors and survival in locoregionally advanced head and neck cancer treated with concomitant chemoradiotherapy: a 9-year, 337-patient, multi-institutional experience. Ann Oncol 15:1179–1186PubMedCrossRef

Cooper JS, Pajak TF, Rubin P et al (1989) Second malignancies in patients who have head and neck cancer: incidence, effect on survival and implications based on the RTOG experience. Int J Radiat Oncol Biol Phys 17:449–456PubMedCrossRef

Lin K, Patel SG, Chu PY et al (2005) Second primary malignancy of the aerodigestive tract in patients treated for cancer of the oral cavity and larynx. Head Neck 27:1042–1048PubMedCrossRef

Chuang SC, Scelo G, Tonita JM et al (2008) Risk of second primary cancer among patients with head and neck cancers: a pooled analysis of 13 cancer registries. Int J Cancer 123:2390–2396PubMedCrossRef

Mabanta SR, Mendenhall WM, Stringer SP et al (1999) Salvage treatment for neck recurrence after irradiation alone for head and neck squamous cell carcinoma with clinically positive neck nodes. Head Neck 21:591–594PubMedCrossRef

10.

Ridge JA (1993) Squamous cancer of the head and neck: surgical treatment of local and regional recurrence. Semin Oncol 20:419–429PubMed

11.

Taussky D, Rufibach K, Huguenin P et al (2005) Risk factors for developing a second upper aerodigestive cancer after radiotherapy with or without chemotherapy in patients with head-and-neck cancers: an exploratory outcomes analysis. Int J Radiat Oncol Biol Phys 62:684–689PubMedCrossRef

12.

Burtness B, Goldwasser MA, Flood W et al (2005) Phase III randomized trial of cisplatin plus placebo compared with cisplatin plus cetuximab in metastatic/recurrent head and neck cancer: an Eastern Cooperative Oncology Group study. J Clin Oncol 23:8646–8654PubMedCrossRef

13.

Vermorken JB, Mesia R, Rivera F et al (2008) Platinum-based chemotherapy plus cetuximab in head and neck cancer. N Engl J Med 359:1116–1127PubMedCrossRef

14.

M. Knoedler, T.C. Gauler, A. Dietz et al (2014) Cetuximab (C), fluorouracil (F) and cisplatin (P) alone or with docetaxel (D) for recurrent/metastatic (RM) head and neck cancer (HNSCC). Final analysis of AIO trial # 1108-CeFCiD. Ann Oncol 25(Suppl 4):iv340–iv356. 10.1093/annonc/mdu340

15.

De Crevoisier R, Bourhis J, Domenge C et al (1998) Full-dose reirradiation for unresectable head and neck carcinoma: experience at the Gustave-Roussy Institute in a series of 169 patients. J Clin Oncol 16:3556–3562PubMed

16.

Kramer NM, Horwitz EM, Cheng J et al (2005) Toxicity and outcome analysis of patients with recurrent head and neck cancer treated with hyperfractionated split-course reirradiation and concurrent cisplatin and paclitaxel chemotherapy from two prospective phase I and II studies. Head Neck 27:406–414PubMedCrossRef

17.

Salama JK, Vokes EE, Chmura SJ et al (2006) Long-term outcome of concurrent chemotherapy and reirradiation for recurrent and second primary head-and-neck squamous cell carcinoma. Int J Radiat Oncol Biol Phys 64:382–391PubMedCrossRef

18.

Sulman EP, Schwartz DL, Le TT et al (2009) IMRT reirradiation of head and neck cancer-disease control and morbidity outcomes. Int J Radiat Oncol Biol Phys 73:399–409PubMedCrossRef

19.

Balermpas P, Keller C, Hambek M et al (2012) Reirradiation with cetuximab in locoregional recurrent and inoperable squamous cell carcinoma of the head and neck: feasibility and first efficacy results. Int J Radiat Oncol Biol Phys 83:e377–e383CrossRef

20.

Langendijk JA, Kasperts N, Leemans CR et al (2006) A phase II study of primary reirradiation in squamous cell carcinoma of head and neck. Radiother Oncol 78:306–312PubMedCrossRef

21.

Watkins JM, Shirai KS, Wahlquist AE et al (2009) Toxicity and survival outcomes of hyperfractionated split-course reirradiation and daily concurrent chemotherapy in locoregionally recurrent, previously irradiated head and neck cancers. Head Neck A 31:493–502CrossRef

22.

Nieder C, Grosu AL, Andratschke NH et al (2006) Update of human spinal cord reirradiation tolerance based on additional data from 38 patients. Int J Radiat Oncol Biol Phys 66:1446–1449PubMedCrossRef

23.

Koutcher L, Sherman E, Fury M et al (2011) Concurrent cisplatin and radiation versus cetuximab and radiation for locally advanced head-and-neck cancer. Int J Radiat Oncol Biol Phys 81:915–922PubMedCrossRef

24.

Huang J, Baschnagel AM, Chen P et al (2014) A matched-pair comparison of intensity-modulated radiation therapy with cetuximab versus intensity-modulated radiation therapy with platinum-based chemotherapy for locally advanced head neck cancer. Int J Clin Oncol 19:240–246PubMedCrossRef

25.

Ye AY, Hay JH, Laskin JJ et al (2013) Toxicity and outcomes in combined modality treatment of head and neck squamous cell carcinoma: cisplatin versus cetuximab. J Cancer Res Ther 9:607–612PubMedCrossRef

26.

Levy A, Blanchard P, Bellefgih S et al (2014) Concurrent use of cisplatin or cetuximab with definitive radiotherapy for locally advanced head and neck squamous cell carcinomas. Strahlenther Onkol 190:823–831PubMedCrossRef

27.

Hu MH, Wang LW, Lu HJ et al (2014) Cisplatin-based chemotherapy versus cetuximab in concurrent chemoradiotherapy for locally advanced head and neck cancer treatment. Biomed Res Int 2014:904341PubMedCentralPubMed

28.

Levy AR, Johnston KM, Sambrook J et al (2011) Indirect comparison of the efficacy of cetuximab and cisplatin in squamous cell carcinoma of the head and neck. Curr Med Res Opin 27:2253–2259PubMedCrossRef

29.

Pajares B, Trigo JM, Toledo MD et al (2013) Differential outcome of concurrent radiotherapy plus epidermal growth factor receptor inhibitors versus radiotherapy plus cisplatin in patients with human papillomavirus-related head and neck cancer. BMC Cancer 13:26PubMedCentralPubMedCrossRef

30.

Riaz N, Sherman E, Koutcher L et al (2014) Concurrent Chemoradiotherapy with cisplatin versus cetuximab for squamous cell carcinoma of the head and neck. Am J Clin Oncol (in press). doi:10.1097/COC.00000000000000006

31.

Zwicker F, Roeder F, Thieke C et al (2011) IMRT reirradiation with concurrent cetuximab immunotherapy in recurrent head and neck cancer. Strahlenther Onkol 187:32–38PubMedCrossRef

32.

Milanović D, Jeremić B, Grosu AL et al (2013) Reirradiation plus EGFR inhibition in locally recurrent and unresectable head and neck cancer: final results from a single institution. Strahlenther Onkol 189:842–848PubMedCrossRef

33.

Lartigau EF, Tresch E, Thariat J et al (2013) Multi institutional phase II study of concomitant stereotactic reirradiation and cetuximab for recurrent head and neck cancer. Radiother Oncol 109:281–285PubMedCrossRef

34.

Heron DE, Rwigema JC, Gibson MK et al (2011) Concurrent cetuximab with stereotactic body radiotherapy for recurrent squamous cell carcinoma of the head and neck: a single institution matched case-control study. Am J Clin Oncol 34:165–172PubMed

35.

Strojan P, Corry J, Eisbruch A et al (2015) Recurrent and second primary squamous cell carcinoma of the head and neck: when and how to reirradiate. Head Neck 37:134–150PubMedCrossRef

36.

Walsh L, Gillham C, Dunne M et al (2010) Toxicity of cetuximab versus cisplatin concurrent with radiotherapy in locally advanced head and neck squamous cell cancer (LAHNSCC). Radiother Oncol 98:38–41PubMedCrossRef

37.

Choe KS, Haraf DJ, Solanki A et al (2011) Prior chemoradiotherapy adversely impacts outcomes of recurrent and second primary head and neck cancer treated with concurrent chemotherapy and reirradiation. Cancer 117:4671–4678PubMedCrossRef

38.

Tanvetyanon T, Padhya T, McCaffrey J et al (2009) Prognostic factors for survival after salvage reirradiation of head and neck cancer. J Clin Oncol 27:1983–1991PubMedCrossRef

39.

Hoff CM, Grau C, Overgaard J. (2012) Effect of smoking on oxygen delivery and outcome in patients treated with radiotherapy for head and neck squamous cell carcinoma—a prospective study. Radiother Oncol 103:38–44PubMedCrossRef

40.

Rades D, Seibold ND, Gebhard MP et al (2011) Prognostic factors (including HPV status) for irradiation of locally advanced squamous cell carcinoma of the head and neck (SCCHN). Strahlenther Onkol 187:626–632PubMedCrossRef

Titel: Re-irradiation with cetuximab or cisplatin-based chemotherapy for recurrent squamous cell carcinoma of the head and neck
verfasst von: Nicolas Dornoff
Christian Weiß, M.D.
Franz Rödel, Ph.D.
Jens Wagenblast, M.D.
Shahram Ghanaati, M.D.
Nateghian Atefeh
Claus Rödel, M.D.
Panagiotis Balermpas, M.D.
Publikationsdatum: 01.08.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 8/2015
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-015-0854-y

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Re-irradiation with cetuximab or cisplatin-based chemotherapy for recurrent squamous cell carcinoma of the head and neck

Abstract

Purpose

Patients and methods

Results

Conclusion

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