Distinctive mucositis and feeding-tube dependency in cetuximab plus radiotherapy for head and neck cancer

Abstract

Prophylactic percutaneous endoscopic gastrostomy is recommended because most patients receiving cetuximab and radiotherapy for locally advanced head and neck squamous cell carcinoma have Grade ≥ 3 mucositis with distinctive features.

Artificial nutrition dependence after cetuximab versus cisplatin combined with radiotherapy for advanced head and neck cancer: A propensity score–matched analysis

“…The use of a feeding tube has been reported to impede the resumption of normal oral eating, as limitations in oral intake prompted disuse atrophy and adverse remodeling of aerodigestive tract muscle, even if the interval of disuse was brief . Patients also had impaired nutritional status, even though vomiting, nausea, and mucositis were reversible . A decline in patient nutritional status impaired immune function and increased dehydration and hospitalization period .…”

Comparison of acute toxicities associated with cetuximab-based bioradiotherapy and platinum-based chemoradiotherapy for head and neck squamous cell carcinomas: A single-institution retrospective study in Japan

“…China and Japan and in this current study [10,17,18]. It is speculated that Asians experience severe mucositis/stomatitis at a higher frequency than Westerners when treated with cetuximab-based BRT.…”

“…In Japan, cetuximab has been available for patients with HNSCC since December 2012. Yokota et al first reported a high incidence (85.7%) of Grade≧3 mucositis/stomatitis in Japanese patients undergoing cetuximab-based BRT and emphasized the need of prophylactic percutaneous endoscopic gastrostomy [10]. We analyzed the incidence of acute toxicities in order to compare the level of safety of cetuximab-based BRT and platinum-based CRT.…”

Investigation of p16 status, chemotherapy regimen, and other nutrition markers for predicting gastrostomy in patients with head and neck cancer

“…This was also the case in the study by Wopken et al who reported that chemotherapy (regardless of the regimen) was a predictor of tube feeding at 6 months after treatment, and, despite different toxicity profiles from different chemotherapy agents, the impact on weight loss and tube feeding is similar . Some studies suggest that the need for nutritional support is even greater in patients receiving cetuximab treatment . As such, it seems that CRT overall, regardless of dose or type, is most important for consideration.…”

“…41 Some studies suggest that the need for nutritional support is even greater in patients receiving cetuximab treatment. 23,42,43 As such, it seems that CRT overall, regardless of dose or type, is most important for consideration.…”