ASTRO: Chemoradiotherapy may be effective head and neck cancer treatment

Eclipse IMRT plan for head and neck cancer Image Source: Varian

A combination of stereotactic body radiotherapy with chemotherapy may be effective in controlling and treating head and neck cancers, according to a study presented Nov. 3 at the annual meeting for the American Society for Radiation Oncology in San Diego.

"Despite clinical advances in the management of locally-advanced head and neck cancers, locoregional tumor recurrence remains a significant challenge," according to the study's lead researcher Dwight E. Heron, MD, vice chairman of the department of radiation oncology at the University of Pittsburgh School of Medicine. Surgical treatment for patients with recurrent, locally advanced head and neck tumors is frequently limited, as are non-surgical options, which may also be associated with short-term responses and significant toxicities, Heron explained.

Twenty-four patients with recurrent, previously irradiated squamous cell carcinoma of the head and neck (SCCHN) that was locoregionally-confined at the start of the study were administered 40 Gy doses of stereotactic radiation therapy in five fractions. Patients received three Cetuximab chemotherapy loading doses, one of C225 400 mg/m² one week prior to radiotherapy and two doses of 225 mg/m² on fractions one and four.

Two of 24 patients experienced complete eradication of targeted tumors and one patient experienced a reduction in targeted lesions of at least 30 percent. Tumors remained stable in 13 patients and progressed in one patient. Median survival was 33 weeks, while median time to progression was 32 weeks. One-year overall survival and progression-free survival rates were 42 percent and 26 percent, respectively.

Toxicity levels of G0 were recorded in 8 percent of patients, G1 in 33 percent, G2 in 46 percent and G3 in 13 percent of patients. The most acute toxicities observed were skin rash (in 18 of 24 participants) and mucositis/dysphagia (16 of 24 patients). No patients experienced toxicity levels of G4 or G5.

Heron and colleagues claimed that their "preliminary results suggest a possible improvement in median survival with the addition of C225 [Cetuximab chemotherapy] to SBRT [stereotactic body radiotherapy] (33 weeks versus 24 weeks) when compared to our previously reported phase I study." The researchers concluded that the radiotherapy plus chemotherapy treatment regiment represents "a feasible and safe treatment option."