RT Journal Article
T1 Paclitaxel Plus Cetuximab as Induction Chemotherapy for Patients With Locoregionally Advanced Head and Neck Squamous Cell Carcinoma Unfit for Cisplatin-Based Chemotherapy
A1 Marín-Jiménez, Juan A
A1 Oliva, Marc
A1 Peinado Martín, Paloma
A1 Cabezas-Camarero, Santiago
A1 Plana Serrahima, Maria
A1 Vázquez Masedo, Manuel Gonzalo
A1 Lozano Borbalas, Alicia
A1 Cabrera Martín, María Nieves
A1 Esteve, Anna
A1 Iglesias Moreno, María Cruz
A1 Vilajosana Altamis, Esther
A1 Arribas Hortigüela, Lorena
A1 Taberna Sanz, Miren
A1 Pérez Segura, Pedro
A1 Mesía, Ricard
AB Objectives: Induction chemotherapy (ICT) followed by definitive treatment is an accepted non-surgical approach for locoregionally advanced head and neck squamous cell carcinoma (LA-HNSCC). However, ICT remains a challenge for cisplatin-unfit patients. We evaluated paclitaxel and cetuximab (P-C) as ICT in a cohort of LA-HNSCC patients unfit for cisplatin.Materials and methods: This is a retrospective analysis of patients with newly diagnosed LA-HNSCC considered unfit for cisplatin-based chemotherapy (age >70 and/or ECOG≥2 and/or comorbidities) treated with weekly P-C followed by definitive radiotherapy and cetuximab (RT-C) between 2010 and 2017. Toxicity and objective response rate (ORR) to ICT and RT-C were collected. Median overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan-Meier method. Cox regression analysis was performed to determine baseline predictors of OS and PFS.Results: A total of 57 patients were included. Grade 3-4 toxicity rate to ICT was 54.4%, and there was a death deemed treatment-related (G5). P-C achieved an ORR of 66.7%, including 12.3% of complete responses (CR). After P-C, 45 patients (78.9%) continued with concomitant RT-C. Twenty-six patients (45.6%) achieved a CR after definitive treatment. With a median follow-up of 21.7 months (range 1.2-94.6), median OS and PFS were 22.9 months and 10.7 months, respectively. The estimated 2-year OS and PFS rates were 48.9% and 33.7%, respectively. Disease stage had a negative impact on OS (stage IVb vs. III-IVa: HR = 2.55 [1.08-6.04], p = 0.03), with a trend towards worse PFS (HR = 1.92 [0.91-4.05], p = 0.09). Primary tumor in the larynx was associated with improved PFS but not OS (HR = 0.45 [0.22-0.92], p = 0.03, and HR = 0.69 [0.32-1.54], p = 0.37, respectively).Conclusion: P-C was a well-tolerated and active ICT regimen in this cohort of LA-HNSCC patients unfit for cisplatin-based chemotherapy. P-C might represent a valid ICT option for unfit patients and may aid patient selection for definitive treatment.
PB Frontiers Research Foundation
YR 2022
FD 2022-07
LK https://hdl.handle.net/20.500.14352/115270
UL https://hdl.handle.net/20.500.14352/115270
LA eng
NO Marín-Jiménez, J. A., Oliva, M., Peinado Martín, P., Cabezas-Camarero, S., Plana Serrahima, M., Vázquez Masedo, G., Lozano Borbalas, A., Cabrera Martín, M. N., Esteve, A., Iglesias Moreno, M. C., Vilajosana Altamis, E., Arribas Hortigüela, L., Taberna Sanz, M., Pérez-Segura, P., & Mesía, R. (2022). Paclitaxel Plus Cetuximab as Induction Chemotherapy for Patients With Locoregionally Advanced Head and Neck Squamous Cell Carcinoma Unfit for Cisplatin-Based Chemotherapy. Frontiers in oncology, 12, 953020. https://doi.org/10.3389/fonc.2022.953020
DS Docta Complutense
RD 3 abr 2025