Intensity-modulated radiotherapy with cisplatin or cetuximab in patients undergoing chemoradiation for squamous cell carcinoma head and neck

Abstract

Author(s): Shruthi Venkateshulu* and Kiran Kumar BR

To study the efficacy, response of weekly cetuximab used concurrently with radiotherapy versus weekly cisplatin with concurrent radiotherapy in loco regionally advanced Head and Neck Squamous Cell Carcinoma (HNSCC). Materials and Methods: Fifty eligible patients were randomly assigned to study arm (Cetuximab arm) and control arm (Cisplatin arm) to receive either intravenous cetuximab 400 mg/m2 or weekly intravenous cisplatin 40 mg/ m2, during RT. RT dose received was 70Gy in 35 fractions with 2Gy/fraction in both the arms. Treatment evaluation was done by assessing tumor response after 6 months follow up period after completion of chemo radiotherapy. Results: Overall Response (OR) rates, which include Complete response (CR) and Partial Response (PR), were assessed in all the treated patients of locally advanced HNSCC at 6 months after completion of treatment. 76% overall response was achieved (CR-56%+PR-20%) in cetuximab arm and 80%(CR52%+PR-28%) in Cisplatin arm (p=1.000). Conclusion: Weekly Cisplatin shows slightly better results in terms of overall response comparing to weekly Cetuximab in our study. Large sample size and longer duration of follow up are needed for strong evaluation of efficacy, to draw inferences on Loco regional Control (LRC) Disease Free Survival (DFS) and Overall Survival (OS).

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