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Single‐arm phase II study of multiagent concurrent chemoradiotherapy and gefitinib in locoregionally advanced squamous cell carcinoma of the head and neck
Author(s) -
Rodriguez Cristina P.,
Adelstein David J.,
Rybicki Lisa A.,
Saxton Jerrold P.,
Lorenz Robert R.,
Wood Benjamin G.,
Scharpf Joseph,
Ives Denise I.
Publication year - 2012
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.21971
Subject(s) - gefitinib , medicine , regimen , chemoradiotherapy , oncology , head and neck cancer , epidermal growth factor receptor , head and neck squamous cell carcinoma , radiation therapy , stage (stratigraphy) , surgery , cancer , paleontology , biology
Background This phase II study tested the addition of the oral epidermal growth factor receptor gefitinib to multiagent concurrent chemoradiotherapy regimen in head and neck squamous cell cancer (HNSCC). Methods Patients with stage III–IV HNSCC received hyperfractionated radiation (72–74.4 Gy at 120 cGy twice daily), with concurrent 96‐hour infusions of cisplatin 20 mg/m 2 /day and fluorouracil 1000 mg/m 2 /day given during weeks 1 and 4. Daily gefitinib 250 mg was started on day 1 of radiation and continued for 2 years. Results were retrospectively compared with our previous study using identical chemoradiotherapy without gefitinib. Results Sixty patients were enrolled in the study; 80% had stage IV disease and 68% had oropharyngeal primary tumors. The full course of gefitinib was not tolerated by 42%; there were 5 treatment‐related deaths (8%). With a median follow‐up of 54 months, 2‐ and 3‐year overall survival estimates were 80% and 71%, respectively. Projected distant metastatic control at 2 and 3 years was 88%. When compared with our historical cohort, acute toxicities including renal dysfunction and unplanned rehospitalization were worse in the study patients. Projected outcome estimates did not differ between the 2 cohorts. Conclusions Addition of gefitinib to concurrent chemoradiotherapy was difficult to complete, did not improve outcomes, and increased toxicity. © 2011 Wiley Periodicals, Inc. Head Neck , 2011