Send to

Choose Destination
Chemotherapy. 2019;64(1):48-56. doi: 10.1159/000500714. Epub 2019 Jun 26.

Efficacy and Safety of Cetuximab plus Radiotherapy in Cisplatin-Unfit Elderly Patients with Advanced Squamous Cell Head and Neck Carcinoma: A Retrospective Study.

Author information

U.O.C. Oncologia, S. Giovanni di Dio Hospital, ASLNA2NORD Frattamaggiore, Naples, Italy,
Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy.
Section of Oncology, Campus Biomedico University, Rome, Italy.
U.O.C. Oncologia, S. Giovanni di Dio Hospital, ASLNA2NORD Frattamaggiore, Naples, Italy.
U.O.C. ORL, Santa Maria Delle Grazie Hospital, ASLNA2NORD, Pozzuoli, Italy.
Dipartimento di Salute Mentale Fisica e Medicina Preventiva, University of Campania "L. Vanvitelli", Naples, Italy.
Ear Nose and Throat Unit, AORN Antonio Cardarelli Hospital, Naples, Italy.
Radiotherapy Unit, Medicina Futura, Acerra, Italy.
Department of Translational Medical Sciences, School of Medicine, University of Campania "L. Vanvitelli", Naples, Italy.



Concurrent platinum-based chemoradiation currently represents the standard treatment for advanced head and neck cancer (HNC), but it induces a significant toxicity, in particular among elderly patients. Elderly and unfit patients have been underrepresented in clinical trials and there is a need for tailored guidelines.


A retrospective review of clinical data of HNC patients treated at the Operative Oncology Unit of the San Giovanni di Dio Hospital in Frattamaggiore (Naples, Italy) was performed. At study entry, a comprehensive assessment including absolute contraindications for cisplatin use, as well as comorbidities, socioeconomic status, BMI, and weight loss, was performed. The treatment included high-dose radiotherapy plus weekly cetuximab (initially at a dose of 400 mg/m2of body surface area and thereafter at 250 mg weekly during the whole radiotherapy). The aim of this study was to evaluate the activity and toxicity of this schedule in a series of patients aged older than 69 years.


Between May 30, 2013, and March 30, 2015, sixty-four patients (age range, 69-87 years; median age, 73.7 years; male/female ratio, 46/18) were treated. The overall response rate was 67% in this series of patients. The disease control rate was 76%. Disease progression was recorded in 25% of the patients. The median duration of loco-regional control was 17 months (range, 15.8-17.7 months). PFS was 14.8 months (range, 13.9-15.5 months). The overall survival was 34 months, with a median follow-up of 41.0 months (range, 31.1-36.8 months). The main grade 3/4 adverse events were acne rash in 52% and radiation dermatitis in 32% of the cases.


Cetuximab plus radiotherapy appears to be feasible and active in elderly patients unsuitable for cisplatin treatment. The treatment was supported by a favorable toxicity profile.


Advanced head and neck cancer; Cetuximab; Chronic alcoholism; Comorbidities; Elderly; Radiotherapy


Supplemental Content

Full text links

Icon for S. Karger AG, Basel, Switzerland
Loading ...
Support Center