Management of radiodermatitis associated with cetuximab in squamous cell carcinomas of the head and neck

Abstract

The objective of this review is to report to the medical community the most recent knowledge on prevention and management of dermatitis with the use of cetuximab simultaneously with radiotherapy in the treatment of squamous cell carcinomas of the head and neck. A review was conducted in PubMed of English language publications between 2010 and 2015. The search employed the terms 'skin toxicity', 'radiodermatitis', 'cetuximab', 'radiotherapy', and 'head and neck cancer'. Data related to the classification and management of dermatitis, associated with cetuximab with concomitant radiotherapy (n = 22), were critically reviewed. We conclude that dermatitis associated with bioradiotherapy is a predictable, treatable, and reversible event that does not affect administration of therapy or its clinical outcome when treated appropriately.

Chamomile Gel versus Urea Cream to Prevent Acute Radiation Dermatitis in Head and Neck Cancer Patients: Results from a Preliminary Clinical Trial

“…The development and severity of acute RD depends on multiple factors intrinsic and extrinsic to the person, including age, sex, diabetes, smoking, tumor site, current treatment, treatment technique, total dose, and fractioned dose. 1,5,23 In this pilot study, the 2 groups evaluated (chamomile gel and urea cream) were balanced on all extrinsic and intrinsic factors that we measured and that could contribute to differences in susceptibility to RD. Therefore, we expect that those factors were not the source of the differences we observed in the figures.…”

Mammalian meat allergy

“…Cetuximab is a recombinant human‐mouse chimeric EGFR monoclonal antibody used in the treatment of squamous cell carcinoma of the head and neck and in metastatic bowel cancer . During its clinical trials in 2007, O'Neil et al .…”

“…Cetuximab is a recombinant human-mouse chimeric EGFR monoclonal antibody used in the treatment of squamous cell carcinoma of the head and neck and in metastatic bowel cancer. 19,20 During its clinical trials in 2007, O'Neil et al 21 reported an increased incidence (22%) of grade 3 or 4 hypersensitivity reactions during or after first infusion in certain American states as compared to the international average of ≤3%. These same patients also reported having episodes of delayed anaphylaxis after ingesting mammalian meat.…”

Radiotherapy‐induced oral morbidities in head and neck cancer patients

“…With regard to the time from RT, early effects are visible during or immediately after RT and may last for 2‐3 weeks following completion of treatment. These include oral mucositis, pain in teeth and gingiva, taste loss, trismus (due to pain), odynophagia, dysphagia, candidosis, radiation dermatitis (RD), and osteoradionecrosis (ORN) 9,10 . Acute issues usually resolve with time, professional guidance, and medication.…”

“…Multiple topical medications and nonpharmacologic agents have been tried in the prevention and treatment of RD but there is no strong evidence to indicate preference between either group of the topical agents 10,105 …”