U.O.C Radioterapia, Ospedale Sant'Andrea, Via di Grottarossa 1035, Roma, Italy.
Radiol Med. 2012 Feb;117(1):125-32. doi: 10.1007/s11547-011-0716-3. Epub 2011 Sep 2.
The authors report acute toxicity in 14 patients with locally advanced head and neck squamous cell carcinoma treated with radiotherapy and cetuximab.
Data collection was performed prospectively on patients treated from September 2007 to March 2009. Treatment consisted of 64.8-70 Gy radiotherapy in conventional fractions and cetuximab.
Two out of 14 patients did not complete the planned combined treatment; radiotherapy was temporarily suspended in six other patients. Seven of 12 patients received cetuximab until the end of radiotherapy. Treatment breaks were principally due to severe acute cutaneous or mucous toxicity. Any grade acneiform rash occurred in all patients. In-field G3-4 cutaneous toxicity occurred in five (36%) patients and G3-4 mucous toxicity in seven (50%). One patient died of sepsis.
In our experience, severe acute toxic reactions are common in patients treated with radiotherapy and concurrent cetuximab, resulting in frequent breaks or incomplete treatment with potential reduction in disease control.
作者报告了 14 例局部晚期头颈部鳞状细胞癌患者接受放疗和西妥昔单抗治疗后的急性毒性。
数据采集是在 2007 年 9 月至 2009 年 3 月期间对接受治疗的患者进行的前瞻性研究。治疗包括常规分次的 64.8-70 Gy 放疗和西妥昔单抗。
14 例患者中有 2 例未完成计划的联合治疗；6 例患者中放疗暂时中断。12 例患者中有 7 例接受了西妥昔单抗治疗直至放疗结束。治疗中断主要是由于严重的急性皮肤或粘膜毒性。所有患者均出现任何级别的痤疮样皮疹。5 例（36%）患者出现 3-4 级皮肤毒性，7 例（50%）患者出现 3-4 级粘膜毒性。1 例患者死于败血症。
根据我们的经验，放疗联合西妥昔单抗治疗的患者常出现严重的急性毒性反应，导致频繁中断治疗或治疗不完全，从而降低疾病控制率。
