Objective: To report the clinical experience of Radiotherapy Department
at University Hospital St. Marina, Varna, with definitive radiotherapy
combined with targeted therapy Cetuximab in patients with locally advanced head and neck carcinoma (LAHNC), the observed toxicity and management protocol.
Materials and Methods: The study included 36 patients with LAHNC who received definitive radiotherapy combined with Cetuximab in the period 2015-2018., VMAT and IGRT irradiation techniques were applied in all patients, with a prescription of total dose to 70Gy in the primary tumor and the involved lymph nodes, based on PET-CT. Cetuximab was administered according to the known protocol. Both Radiotheray and Medical Oncology Departments of the University Hospital “St. Marina” – Varna elaborated common protocol for premedication. The side effects were evaluated by the treating physician according to the CTCAE vers. 4.0.
Results: During the application of the loading dose, an anaphylactic reaction was observed in 6 out of all 36 patients. The reduction of maintenance doses with 75% was done only in two patients without interruption of radiotherapy schedule and the planned infusions. One patient refuses to continue therapy. One patient died of cardiac comorbidity in the second week. All the others 26 patients completed the full course radiotherapy combined with full dose target therapy, with only moderate toxicity up to grade 3. No haematological toxicity was observed.
Conclusion: The reported patients compliance was high 75%, with no higher than grade 3 side effects and a good quality of life. To our knowledge currently, this is the first study in Bulgarian clinical practice regarding the application of Cetuximab in combination with radiation therapy and reporting of early toxicity and patients compliance.
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