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Concurrent Radiotherapy With Cetuximab or Platinum-based Chemotherapy for Locally Advanced Cutaneous Squamous Cell Carcinoma of the Head and Neck

Lu, Sharon M. MD; Lien, Winston W. MD

American Journal of Clinical Oncology: January 2018 - Volume 41 - Issue 1 - p 95–99
doi: 10.1097/COC.0000000000000228
Original Articles: Head and Neck

Objectives: The management of high-risk cutaneous squamous cell carcinoma of the head and neck (SCCHN) is not well defined. We review outcomes in patients with locally advanced cutaneous SCCHN treated with radiation and concomitant platinum (Pt)-based chemotherapy or cetuximab (Cx).

Methods: We identified 23 patients treated at our institution from 2007 to 2014. Systemic therapy consisted of Pt-based chemotherapy for 15 (65%) patients and Cx for 8 (35%) patients. Treatment intent was definitive for 48% and adjuvant for 52% of the cases.

Results: The majority (87%) of patients had stage III/IV disease and 9 (39%) patients had unresectable disease. All patients were being treated for recurrent disease. Aside from median age (59 Pt vs. 71 Cx, P=0.04), there were no significant differences in patient and tumor characteristics between those receiving Pt versus Cx therapy. At mean follow-up of 24 months, locoregional recurrence and distant failure were observed in 52% and 17% of all patients, respectively. Estimated 2-year disease-free survival and overall survival in the Cx versus Pt groups were: 50% versus 30% (P=0.25), and 73% versus 40% (P=0.32), respectively.

Conclusions: Radiotherapy with either concurrent Pt or Cx appears to offer similar clinical outcomes in patients with locally advanced cutaneous SCCHN.

Department of Radiation Oncology, Kaiser Permanente Southern California, Los Angeles, CA

The authors declare no conflicts of interest.

Reprints: Sharon M. Lu, MD, Department of Radiation Oncology, Kaiser Permanente Southern California, 4950 Sunset Blvd, Los Angeles, CA 90027. E-mail: sharon.m.lu@gmail.com.

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