Efficacy and Feasibility of Induction Chemotherapy and Radiotherapy plus Cetuximab in Head and Neck Cancer

Background: To determine the potential activity and tolerability of sequential treatment in head and neck cancer, we conducted a phase II trial based on induction chemotherapy of two cycles of taxotere, cisplatin and 5- fluorouracil followed by radiotherapy plus weekly cetuximab. Patients and Methods: Thirty-six patients with stage III or IV squamous cell carcinoma of the oral cavity, larynx, oropharynx and hypopharynx were treated and evaluated for response and acute toxicity. Results: Eighty-one percent of patients had stage IV disease and 42% had hypopharyngeal and oral cavity primaries. The overall response rate was 81.8%, with 60.6% complete response and 33.3% partial response. Severe toxicities were febrile neutropenia (6%) during induction chemotherapy and dermatitis (48%), mucositis (33%) and dysphagia (12%) during the concurrent phase. Conclusion: Our protocol proved to be feasible, effective and well tolerated. This sequential strategy should be further investigated. Current management of locally advanced head and neck squamous cell carcinoma (HNSCC) usually involves the combination of multiple therapies. Several trials showed that concurrent chemoradiotherapy (CT/RT), usually with a cisplatin-based regimen, improves survival rates when