Min Yao1, Charles Woods1, Pierre Lavertu2, Pingfu Fu3, Michael Gibson4, Rod Rezaee2, Chad Zender2, Jay Wasman5, Neelesh Sharma4, Mitchell Machtay1, Panayiotis Savvides4. 1. Department of Radiation Oncology, University Hospitals Case Medical Center, Seidman Cancer Hospital, Cleveland, Ohio. 2. Department of Otolaryngology - Head and Neck Surgery, University Hospitals Case Medical Center, Seidman Cancer Hospital, Cleveland, Ohio. 3. Department of Epidemiology and Biostatistics, Case Western Reserve University School of Medicine, Cleveland, Ohio. 4. Department of Internal Medicine (Medical Oncology), University Hospitals Case Medical Center, Seidman Cancer Hospital, Cleveland, Ohio. 5. Department of Pathology, University Hospitals Case Medical Center, Seidman Cancer Hospital, Cleveland, Ohio.
Abstract
BACKGROUND: The purpose of this study was to establish the efficacy and toxicities of concurrent erlotinib and docetaxel with intensity-modulated radiotherapy (IMRT) for locally advanced head and neck squamous cell carcinoma (HNSCC). METHODS: Patients received daily erlotinib for 2 weeks, followed by daily IMRT with concurrent weekly docetaxel and daily erlotinib, followed by daily erlotinib for up to 2 years. The primary objective was disease-free survival (DFS). Secondary objectives included overall survival (OS), patterns of failure, and toxicities. Forty-three patients were recruited for this study. RESULTS: With a median follow-up of 48.7 months, the 3-year DFS, OS, locoregional failure-free survival, and distant metastasis-free survival was 69.5%, 81%, 82.4%, and 83.7%, respectively. The most common grade III/IV local toxicities were dysphagia, dermatitis, and mucositis. Patients with p16-positive tumors had significantly better outcomes. CONCLUSION: The regimen is tolerable and effective. It is worthy of further investigation in selected patients and may be useful in patients who cannot tolerate cisplatin.
BACKGROUND: The purpose of this study was to establish the efficacy and toxicities of concurrent erlotinib and docetaxel with intensity-modulated radiotherapy (IMRT) for locally advanced head and neck squamous cell carcinoma (HNSCC). METHODS:Patients received daily erlotinib for 2 weeks, followed by daily IMRT with concurrent weekly docetaxel and daily erlotinib, followed by daily erlotinib for up to 2 years. The primary objective was disease-free survival (DFS). Secondary objectives included overall survival (OS), patterns of failure, and toxicities. Forty-three patients were recruited for this study. RESULTS: With a median follow-up of 48.7 months, the 3-year DFS, OS, locoregional failure-free survival, and distant metastasis-free survival was 69.5%, 81%, 82.4%, and 83.7%, respectively. The most common grade III/IV local toxicities were dysphagia, dermatitis, and mucositis. Patients with p16-positive tumors had significantly better outcomes. CONCLUSION: The regimen is tolerable and effective. It is worthy of further investigation in selected patients and may be useful in patients who cannot tolerate cisplatin.
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