Severe gastrointestinal bleeding in patients with locally advanced head and neck squamous cell carcinoma treated by concurrent radiotherapy and Cetuximab

Naoya Murakami, Seiichi Yoshimoto, Fumihiko Matsumoto, Takao Ueno, Yoshinori Ito, Satoru Watanabe, Kazuma Kobayashi, Ken Harada, Mayuka Kitaguchi, Shuhei Sekii, Kana Takahashi, Kotaro Yoshio, Koji Inaba, Madoka Morota, Minako Sumi, Yutaka Saito, Jun Itami

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)

Abstract

Purpose: Concurrent administration of Cetuximab with radiotherapy (Cetuximab-radiation) has been accepted as an alternative option for locally advanced head and neck squamous cell carcinoma (HNSCC). The purpose of this study was to retrospectively compare complications of Cetuximab-radiation with those of concurrent chemoradiation (cCRT) with a special concern on gastrointestinal (GI) hemorrhage associated with Cetuximab-radiation. Methods: Indication of Cetuximab-radiation/cCRT for locally advanced HNSCC was primary, postoperative adjuvant, or salvage after recurrence. Our first choice for patients with advanced HNSCC was cCRT; however, if patients did not have enough organ function but with a favorable performance status, Cetuximab-radiation was applied. Results: From April 2013 to March 2014, 30 patients were identified who were treated with Cetuximab-radiation or cCRT and each cohort consisted of 15 patients. Patients in Cetuximab-radiation cohort suffered from a statistically higher rate of G3/4 dermatitis compared with cCRT cohort (80 vs. 13.3 %, respectively, p < 0.001). More patients required unexpected hospitalization due to deterioration of their general condition and total parenteral nutrition in Cetuximab-radiation cohort (p = 0.011 and p = 0.025, respectively). While none experienced GI bleeding in cCRT cohort, four patients experienced GI bleeding including two grade 4 bleeding in Cetuximab-radiation cohort (p = 0.05). Conclusions: It is probable that there exists a group of patients who are susceptible for Cetuximab-radiation not only in terms of well-known dermatitis and mucositis but also of gastrointestinal complications.

Original languageEnglish
Pages (from-to)177-184
Number of pages8
JournalJournal of cancer research and clinical oncology
Volume141
Issue number1
DOIs
Publication statusPublished - Jan 1 2015
Externally publishedYes

Keywords

  • Adverse effect
  • Cetuximab
  • EGFR inhibitor
  • Gastrointestinal bleeding
  • Head and neck squamous cell carcinoma
  • Radiation therapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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