Significance of induction chemotherapy combined with cetuximab in laryngeal preservation rate of locally advanced hypopharyngeal cancer.

Abstract

e18078 Background: Anatomical and functional laryngeal organ preservation is critical for patients with locally advanced hypopharyngeal squamous cell carcinoma (LAHSCC). Induction chemotherapy with taxanes (T), cisplatin (P) and 5-FU (F) is a therapeutical option in patients with a strong desire to preserve the throat, whether enhanced induction chemotherapy (TPF/TP combined with cetuximab) can improve laryngeal preservation rate (LPR) and objective response rate (ORR) of LAHSCC remains controversial. Here we report the results of a retrospectively study comparing TPF/TP with TPF/TP plus cetuximab. Methods: Nanfang Hospital database was retrospectively queried for LAHSCC patients who received 2 cycle induction chemotherapy with TPF/TP (paclitaxel, cisplatin, 5-Fu) with or without concurrent use of cetuximab for ORR. Results: A total of 81 patients were identified including 36 which had concurrent use of TPF/TP and cetuximab. The overall ORR was 71.60% (58/81), patients in the TPF/TP +Cetuximab group had significantly improved ORR (83.33% (30/36) vs 62.22% (28/45) (P = 0.037) compared to TPF/TP group. After IC, 24 patients underwent laryngopharyngectomies, 6 underwent larynx-preserving surgeries, 51 underwent CCRT and 3 received salvage surgeries. In addition, the total 3-month laryngeal preservation rate (LPR) was 69.13% (56/81), the cetuximab-associated LPR benefit was observed in patients with 60.0% (27/45) in the TPF/TP group, and 80.56% (29/36) in the TPF/TP +Cetuximab group (P < 0.001). The adverse events of grade 3 or 4 were similar between the two groups except for skin rash (TPF/TP group 6.7% vs TPF/TP+Cetuximab 41.7%, P < 0.001), which gradually subsided within 2 weeks after the drug withdrawal. Conclusions: Concurrent cetuximab use with TPF/TP induction chemotherapy in LAHSCC patients was associated with improved ORR and short-term LPR, with tolerable toxicity. Further prospective evidence from larger trials is warranted.