Title: Radiotherapy plus EGFR inhibitor- Geftinib, a single Institutional Experience

Authors: Dr Aachum Kichu, Dr Madhumathi, DMRT, MDRT

 DOI: https://dx.doi.org/10.18535/jmscr/v7i8.67

Abstract

Context: Concurrent chemoradiotherapy in locally advanced squamous cell carcinoma of head and neck with Gefitinib and Cisplatin

Aims: The aim of this study was to evaluate the use of Gefitinib and weekly Cisplatin concurrently with conventional radiation in locally advanced squamous cell carcinoma of head and neck.

Settings and Design: Single arm prospective study with a Phase II design.30 patients presenting to the department of Radiotherapy with locally advanced head and neck squamous cell carcinoma fulfilling the inclusion criteria were recruited for the study.

Methods and Material: Single arm prospective study with a Phase II design.

Statistical Analysis Used: Observational analysis

Results: 76.6% of patients had complete response and 23.4% had partial response to the treatment.

Conclusions: the problem of head and neck cancer continues to grow. More amount of patients are presenting with locally advanced cancers. The addition of Gefitinib to the standard concurrent chemoradiation protocol seems to be a good option showing a better response rates than the standard arm. The regimen is also well tolerated with no severe increase in the toxicity and patient compliance is good.

Keywords: Chemoradiotherapy, Geftinib, locally advanced squamous cell carcinoma of Head & Neck.

Key Messages: Addition of Geftinib to chemoradiation shows better response rate.

References

  • Horiot J-C, Le Fur R, N'Guyen T, et al.: Hyperfractionation versus conventional fractionation in oropharyngeal carcinoma: final analysis of a randomized trial of the EORTC cooperative group of radiotherapy. RadiotherOncol 25: 231-241, 1992
  • Overgaard .1, Sand Hansen H, Sapru W, et al.: Conventionalradiotherapy as the primary treatment of squamous cellcarcinoma of the head and neck: Arandomized multicentre study of 5 versus 6 fractions per week - preliminary reportfrom the DAHANCA 6 and 7 trial. RadiotherOncol 40:S31 1996
  • Pignon JP, Bourhis J, Domenge C, Designé L. Chemotherapy added to locoregional treatment for head and neck squamous‑cell carcinoma: Three meta ‑analyses of updated individual data. MACH‑NC Collaborative Group. Meta‑Analysis of chemotherapy on head and neck cancer. Lancet 2000;355:949‑
  • Homma A, Inamura N, Oridate N, Suzula S, concomitant weekly Cisplatin and radiotherapy for head and neck cancer. Jpn J Clin Oncol.2011 aug ; 41(8) ; 980-6.
  • Tejpal Gupta, Jai P Agarwal, Sarbani Ghosh Laskar, Purvish M Parikh, Radical Radiotherapy with concurrent weekly Cisplatin in loco regionally advanced squamous cell carcinomas of head and neck: a single institution experience. Head and neck oncology 2009 1 (17)
  • Traynor AM, Richards GM, Hartig GK, Khuntia D, Comprehensive IMRT plus weekly cisplatin for advanced head and neck cancer. ; The University of Wisconsin Experience, Head and neck Sept.2009 Wiley Periodicals Inc.
  • Changhu Chen et al, Phase I Trial of Gefitinib in Combination With Radiation or Chemoradiation for Patients With Locally Advanced Squamous Cell Head and Neck Cancer. J Clin Oncol 25:4880-4886. © 2007 by American Society of Clinical Oncology
  • Bella Pajares et al. Differential outcome of concurrent radiotherapy plus epidermal growth factor receptor inhibitors versus radiotherapy plus cisplatin in patients with human papillomavirus-related head and neck cancer. Pajares et al. BMC Cancer 2013, 13:26 http://www.biomedcentral.com/1471-2407/13/26
  • Bhattacharya et al. A prospective randomised controlled trial of concurrent chemoradiation versus concurrent chemoradiation along with gefitinib in locally advanced squamous cell carcinoma of head and neck. Clinical Cancer Investigation Journal | March-April-2014 | Vol 3 | Issue 2
  • Charu Singh. Gefitinib with concurrent chemoradiation in locally advanced head and neck cancers. J Clin ncol 32:5s, 2014

Corresponding Author

Dr Madhumathi, DMRT, MDRT

Sr. Assistant Professor, Department of Radiotheraphy Barnard Institute of Radiology and Oncology, Madras Medical College, Chennai – 600001