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A phase II study of concurrent cetuximab-cisplatin and intensity-modulated radiotherapy in locoregionally advanced nasopharyngeal carcinoma
B.B.Y. Ma; M.K.M. Kam; S.F. Leung; E.P. Hui; A.D. King; S.L. Chan; F. Mo; H. Loong; B.K.H. Yu; A. Ahuja; et al. (Profiled Authors: Anthony Tak-cheung Chan; Brigette Buig-yue Ma; Stephen Lam Chan; Edwin Pun Hui; Sing-fai Leung)
Annals of Oncology. 2012;23(5):1287-1292.Abstract
Background: Based on our previous work on the clinical activity of cetuximab in recurrent nasopharyngeal carcinoma (NPC), we evaluated the feasibility of adding cetuximab to concurrent cisplatin and intensity-modulated radiotherapy (IMRT) in locoregionally advanced NPC. Patients and methods: Patients with American Joint Committee on Cancer stage III-IVB NPC were given an initial dose of cetuximab (400 mg/m. 2) 7-10 days before receiving concurrent IMRT, weekly cisplatin (30 mg/m. 2/week) and cetuximab (250 mg/m. 2/week). Results: Thirty patients (median age of 45 years) with stage III (67%), IVA (30%) and IVB (3%) nonkeratinizing NPC were enrolled. Grade 3-4 oropharyngeal mucositis occurred in 26 (87%) patients and 10 (33%) patients required short-term nasogastric feeding. Grade 3 radiotherapy-related dermatitis occurred in six patients (20%) and three patients (10%) had grade 3 cetuximab-related acneiform rash. These grade 3-4 skin and mucosal toxic effects were manageable and reversible. At a median follow-up of 31.8 months [95% confidence interval (CI) 26.2-32.1 months], the 2-year progression-free survival was 86.5% (95% CI 74.3% to 98.8%). Conclusions: Concurrent administration of cetuximab, weekly cisplatin and IMRT is a feasible strategy against locoregionally advanced NPC. Preliminary survival data compare favorably with historic data and further follow-up is warranted. © The Author 2011. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.
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