Anticancer Section / Original Paper

Morse R. · Ganju R.G. · Neeranjun R. · Gan G.N. · Cao Y. · Neupane P. · Kakarala K. · Shnayder Y. · Lominska C.E.

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Article / Publication Details Abstract

Abstract Introduction: Standard of care for radiosensitization in head and neck squamous cell carcinoma (HNSCC) is concurrent chemoradiotherapy (CCRT) with high-dose cisplatin. The optimal chemoradiation regimen for patients medically unfit for cisplatin is unclear. We compared our experience with concurrent cetuximab versus other cytotoxic non-cisplatin agents. Methods: We reviewed 53 patients between 2011 and 2017 with HNSCC treated with CCRT ineligible for cisplatin. Chemotherapy and radiotherapy treatment tolerance was evaluated in those receiving cetuximab (CTX) versus non-cetuximab chemotherapy (NCC). Of the NCC regimens, the majority were carboplatin/paclitaxel and were dosed at an area under the curve (AUC) of 2 and 45-50 mg/m2, respectively. Standard radiation dosing was 70 Gray (Gy) in the definitive setting and 60-66 Gy in the post-operative setting. Patient characteristics and treatment toxicities were evaluated using categorical methods. Results: Patients were well balanced overall including differences between performance status and comorbidity score. NCC patients experienced more radiation treatment breaks (52.4% versus 21.9%, p=0.022), radiation delays >1 week (33.3% versus 3.1%, p

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