Abstract
e17553 Background: Cisplatin toxicities substantially increased in elderly patients with head and neck cancer, when it is given as CRT. Bio-radiotherapy using cetuximab could offer a less toxic alternative. The purpose of this retrospective study is to evaluate the compliance of cetuximab versus cisplatin in CRT for HNSCC pts 70 years of age or old pts. Methods: We included over 70 years old patients treated by radio chemotherapy in head and neck cancer. Severity of AE was measured by the percentage of the drug dose reduction. Dose is considered reduced if patient did not receive 200mg/m² in cisplatin group, and if he did not receive the seven planned cycles in cetuximab group. We recalculated the dose reduction percentage including over 65 years old patientes. Results: We enrolled 37 over 70 years pts, middle age 74.5(from 70 to 88). 23 pts were treated by cetximab-RT compared to 14 treated by cisplatin-RT. 30% of pts (7 of 23 pts) in cet-RT group received a dose reduction versus 28% (4 of 14 pts) in cisplatin-RT group. Then, compliance to cetuximab is comparable to cisplatin and dose reduction is close.This finding disclaim a general assumption that cetuximab is better tolerated than cisplatin concurrently to radiotherapy in elderly pts. When we recalculated the dose reduction including also over 65 years old pts, we endrolled 64 pts, dose reduction in cet-RT pts remains about 28% (10 of 35pts) versus only 17% (5 of 29) in cisplatin-RT group. A clear increasing in dose reduction of cisplatin appears once pts passed 70 years old. Finally, we redistributed the 35 cetuximab-RT pts according to period of treatment, the first group included pts treated between 2007 and 2011, dose reduction was 35% (7 of 20patients),the second group included pts treated between 2012 and 2016, dose reduction was only 20% (3 of 15). This supports that good handling of cetuximab's toxicities improves the treatment's compliance. Conclusions: Dose reduction in elderly pts is equal in cetuximab and cisplatin. Dose reduction to cisplatin clearly increases among over 70years old pts. Good handling of cetuximab improves the compliance to treatment
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