Purpose: The standard of care for Locoregionally Advanced Squamous Cell Carcinoma of Head and Neck (LASCCHN) is concurrent chemoradiation. The most common chemotherapeutic agent used is cisplatin (CDDP) given three weekly or weekly. Cetuximab (CTX) is the alternative agent for patients clinically unfit for CDDP. The present study was carried out to compare toxicity, tolerability, locoregional control (LRC) and overall survival (OS) in patients receiving CDDP versus CTX.
Materials and methods: The present retrospective study was carried out at department of Radiotherapy, SMS Medical College, Jaipur; during July 2015 to June 2016 on patients with LASCCHN of oral cavity, oropharynx, hypopharynx and laryngopharynx treated with definitive radiotherapy (70 Gy in 35 fractions) concurrently with either CDDP (40 mg/m2 IV every week) or CTX (400 mg/m2 followed by 250 mg/m2 every week). A total of 64 patients were found eligible, 43 patients in CDDP arm and 21 patients in CTX arm.
Results: Treatment interruptions, requirement of parenteral nutrition and feeding naso-gastric tube insertion were significantly higher in CTX arm compared to CDDP arm (P = 0.005, 0.04, & 0.003, respectively). CTX arm demonstrated significantly more grade II or higher acute dermatitis (P = 0.03) and infusion reactions (P = 0.003); whereas leucopenia and vomiting was significantly higher in CDDP arm (P = 0.04 and <0.001, respectively). At last follow up, there was no significant difference in LRC rate & OS of CDDP arm (86% & 86%) and CTX arm (82.6% & 71.4%), respectively.
Conclusion: Treatment interruptions, requirement of parenteral nutrition & nasogastric feeding, acute dermatitis, and infusion reactions were significantly higher in CTX arm; whereas leucopenia and vomiting was significantly higher in CDDP arm. No difference was noted in LRC and OS between the two groups.
Impact Factor
2022: 6.012
This work is licensed under a