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Neue Aspekte der primären Radiochemotherapie bei Kopf-Hals-Tumoren

Highlights vom ASCO-Kongress 2011

New aspects of primary radiochemotherapy in head and neck cancer

Highlights from the 2011 ASCO Congress

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Zusammenfassung

Die primäre Radiochemotherapie ist vor allem bei Patienten zu erwägen, deren Organfunktion postoperativ nicht erhalten werden kann oder bei nichtresektablen Tumoren. Die intensitätsmodulierte Radiotherapie (IMRT) scheint zu einer geringeren Spättoxizität und damit zu einer Verbesserung der Lebensqualität zu führen. Ob die IMRT im Vergleich zu einer konventionellen Radiotherapie zu einer Verbesserung der lokalen Kontrolle führt, bleibt weiterhin offen. Die Langzeittoxizitäten der jeweiligen Therapie sind mit dem Patienten abzuwägen, um eine optimale Therapie mit minimalen Risiken zu erreichen. Neuere Ansätze mit einer Kombination aus Bestrahlung und biologischen Targettherapeutika sind ebenfalls eine Option. Diese Substanzen werden vermehrt in Therapieprotokolle integriert. Die prätherapeutischen Selektionskriterien für ein gutes Ansprechen auf eine sog. Targettherapie fehlen bislang.

Abstract

Primary radiochemotherapy is a treatment option for patients with locally advanced or unresectable head and neck cancer. Compared to conventional radiotherapy, intensity-modulated radiotherapy (IMRT) is associated with fewer long-term toxicities and better quality of life. Whether IMRT improves local control in these patients needs to be further investigated. The risk factors and treatment toxicities must be taken into consideration and discussed with the patients. New approaches combining radiotherapy and biological targets are a treatment option. The implementation of these substances in treatment protocols is increasing. Sensitive and specific prognostic biomarkers for patient identification to optimize treatment selection are important, but reliable parameters are still missing.

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Literatur

  1. Adelstein DJ, Li Y, Adams Gl et al (2003) An intergroup phase III comparison of standard radiation therapy and two schedules of concurrent chemoradiotherapy in patients with unresectable squamous cell head and neck cancer. J Clin Oncol 21:92–98

    Article  PubMed  Google Scholar 

  2. Ang KK, Zhang QE, Rosenthal DI et al (2011) A randomized phase III trial (RTOG 0522) of concurrent accelerated radiation plus cisplatin with or without cetuximab for stage III-IV head and neck squamous cell carcinomas (HNC). ASCO Meeting Abstracts 29:5500

    Google Scholar 

  3. Bonner JA, Harari PM, Giralt J et al (2006) Radiotherapy plus cetuximab for squamous-cell carcinoma of the head and neck. N Engl J Med 354:567–578

    Article  PubMed  CAS  Google Scholar 

  4. Bonner JA, Harari PM, Giralt J et al (2010) Radiotherapy plus cetuximab for locoregionally advanced head and neck cancer: 5-year survival data from a phase 3 randomised trial, and relation between cetuximab-induced rash and survival. Lancet Oncol 11:21–28

    Article  PubMed  CAS  Google Scholar 

  5. Burri RJ, Lee NY (2009) Concurrent chemotherapy and radiotherapy for head and neck cancer. Expert Rev Anticancer Ther 9:293–302

    Article  PubMed  Google Scholar 

  6. Chew A, Hay J, Laskin JJ et al (2011) Toxicity in combined modality treatment of HNSCC: cisplatin versus cetuximab. ASCO Meeting Abstracts 29:5526

    Google Scholar 

  7. Espeli V, Zucca E, Ghielmini MEG et al (2011) Weekly and 3-weekly cisplatin concurrent with intensity-modulated radiotherapy in locally advanced head and neck squamous cell cancer. ASCO Meeting Abstracts 29:5555

    Google Scholar 

  8. Forastiere AA, Goepfert H, Maor M et al (2003) Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. N Engl J Med 349:2091–2098

    Article  PubMed  CAS  Google Scholar 

  9. Ghi MG, Paccagnella A, Floriani I et al (2011) Concomitant chemoradiation in locally advanced head and neck squamous cell carcinoma: a literature-based meta-analysis on the platinum concomitant chemotherapy. ASCO Meeting Abstracts 29:5534

    Google Scholar 

  10. Kies MS, Holsinger FC, Lee JJ et al (2010) Induction chemotherapy and cetuximab for locally advanced squamous cell carcinoma of the head and neck: results from a phase II prospective trial. J Clin Oncol 28:8–14

    Article  PubMed  CAS  Google Scholar 

  11. Kose F, Besen AA, Sumbul AT et al (2011) Weekly cisplatin versus standard three-weekly cisplatin in concurrent chemoradiotherapy of head and neck cancer: Baskent University experience. ASCO Meeting Abstracts 29:e16001

    Google Scholar 

  12. Lefebvre J, Pointreau Y, Rolland F et al (2011) Sequential chemoradiotherapy (SCRT) for larynx preservation (LP): results of the randomized phase II TREMPLIN study. ASCO Meeting Abstracts 29:5501

    Google Scholar 

  13. Lefebvre Jl (2005) Current clinical outcomes demand new treatment options for SCCHN. Ann Oncol 16(Suppl 6):vi7-vi12

    Article  PubMed  Google Scholar 

  14. Orus C, Leon X, Vega M et al (2000) Initial treatment of the early stages (I, II) of supraglottic squamous cell carcinoma: partial laryngectomy versus radiotherapy. Eur Arch Otorhinolaryngol 257:512–516

    Article  PubMed  CAS  Google Scholar 

  15. Otty ZA, Sabesan SS, Buhrer Skinner M (2011) Efficacy of weekly cisplatin 40 mg/m2 in definitive and adjuvant chemoradiation of head and neck cancer: a retrospective analysis. ASCO Meeting Abstracts 29:e16039

    Google Scholar 

  16. Pajares B, Trigo Perez JM, Toledo MD et al (2011) Human papillomavirus (HPV)-related head and neck squamous cell carcinoma (HNSCC) and outcome after treatment with epidermal growth factor receptor inhibitors (EGFR inhib) plus radiotherapy (RT) versus conventional chemotherapy (CT) plus RT. ASCO Meeting Abstracts 29:5528

    Google Scholar 

  17. Pignon JP, Le Maitre A, Maillard E et al (2009) Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiother Oncol 92:4–14

    Article  PubMed  Google Scholar 

  18. Posner MR, Hershock DM, Blajman CR et al (2007) Cisplatin and fluorouracil alone or with docetaxel in head and neck cancer. N Engl J Med 357:1705–1715

    Article  PubMed  CAS  Google Scholar 

  19. Raimondo L, Garzaro M, Riva G et al (2011) Long-term toxicity: a comparison between surgery plus radiotherapy and exclusive chemoradiation therapy regimes in oropharyngeal cancer patients. ASCO Meeting Abstracts 29:5535

    Google Scholar 

  20. Rosenthal DI, Gunn GB, Mendoza TR et al (2011) Long-term symptom burden after radiation treatment for oropharynx cancer: a comparison of 3D and IMRT techniques. ASCO Meeting Abstracts 29:5539

    Google Scholar 

  21. Seiwert TY, Haraf DJ, Cohen EE et al (2011) A randomized phase II trial of cetuximab-based induction chemotherapy followed by concurrent cetuximab, 5-FU, hydroxyurea, and hyperfractionated radiation (CetuxFHX), or cetuximab, cisplatin, and accelerated radiation with concomitant boost (CetuxPX) in patients with locoregionally advanced head and neck cancer (HNC). ASCO Meeting Abstracts 29:5519

    Google Scholar 

  22. Sharma A, Mohanti BK, Thakar A et al (2011) Concomitant chemoradiation using weekly cisplatin for advanced squamous cell carcinoma of head and neck: experience from a tertiary cancer center in India. ASCO Meeting Abstracts 29:5548

    Google Scholar 

  23. Vermorken JB, Remenar E, Van Herpen C et al (2007) Cisplatin, fluorouracil, and docetaxel in unresectable head and neck cancer. N Engl J Med 357:1695–1704

    Article  PubMed  CAS  Google Scholar 

  24. Wanebo HJ, Ghebremichael MS, Burtness B et al (2010) Phase II induction cetuximab (C225), paclitaxel (P), and carboplatin (C) followed by chemoradiation with C225, P, C, and RT 68–72 Gy for stage III/IV head and neck squamous cancer: primary site organ preservation and disease control at 2 years (ECOG, E2303). J Clin Oncol (Meeting Abstracts) 28:5513

    Google Scholar 

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehungen hin: C.-J. Wang gibt an, dass kein Interessenkonflikt besteht. R. Knecht ist Mitglied von Advisory Boards für Merck Serono, Sanofi Aventis, Boehringer Ingelheim und Bayer Healthcare Leverkusen.

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Authors and Affiliations

  1. Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland

    S. Laban,  C.J. Wang, R. Knecht & A. Münscher

  2. Ambulanzzentrum Bereich Strahlentherapie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

    S. Tribius

Authors
  1. S. Laban
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  2. C.J. Wang
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  3. R. Knecht
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  4. S. Tribius
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  5. A. Münscher
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Correspondence to C.J. Wang.

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SL und CJW haben gleichermaßen zum Inhalt des Artikels beigetragen.

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Laban, S., Wang, C., Knecht, R. et al. Neue Aspekte der primären Radiochemotherapie bei Kopf-Hals-Tumoren. HNO 60, 393–397 (2012). https://doi.org/10.1007/s00106-011-2463-0

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  • DOI: https://doi.org/10.1007/s00106-011-2463-0

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