EGFr inhibitor toxicityHigh rate of severe radiation dermatitis during radiation therapy with concurrent cetuximab in head and neck cancer: Results of a survey in EORTC institutes
Section snippets
Materials and methods
A formal questionnaire was developed which was composed of two parts (see Appendix). In the first part of the questionnaire, we evaluated which institutions are currently using cetuximab concurrently with radiotherapy in HNSCC patient and how many patients had been treated so far and which proportion of these patients developed grades 3–4 skin reactions within the radiation portals. In the second part of the questionnaire, details of those patients that had developed a grade III or IV skin
Results
The questionnaire was sent via E-Mail to the members of the EORTC Head and Group and Radiation Oncology Group (111 institutes). Twenty-eight institutes from eleven countries (United Kingdom, Belgium, the Netherlands, Spain, Austria, Switzerland, Italy, France, Germany, Serbia, Israel) responded. One Institute retracted their data (Vienna). Fifteen out of these 28 institutions (54%) indicated that they had been treating HNSCC patients with radiotherapy and concurrent cetuximab. In case of
Discussion
The results of this survey indicate that grades III and IV radiation dermatitis occurs in approximately 49% of HNSCC patients treated with radiotherapy and concurrent cetuximab. The incidence of these severe skin reactions is twice as high compared to that reported by Bonner et al. [1]. Even more cumbersome is the high rate of grade IV skin reactions – 28% – within the radiation portals, because these severe reactions are potentially hazardous due to secondary local and systemic infections [2].
Conclusion
The results of this survey indicate that the concurrent use of cetuximab during radiotherapy of head and neck cancer maybe associated with a high incidence of severe (grade III/IV) radiation dermatitis. Close monitoring for the occurrence of such severe skin reactions within the radiation portals is necessary and interruption of further treatment with cetuximab during radiotherapy is recommended in case of early grade III–IV radiation dermatitis. In future trials in which cetuximab is combined
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