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Severe radiation dermatitis in patients with locally advanced head and neck cancer treated with concurrent radiation and cetuximab
American Journal of Clinical Oncology, 10/06/09

Koutcher LD et al. – Treatment with concurrent radiation and cetuximab for locally advanced HNC is a relatively new treatment modality, and the toxicities of this regimen are becoming better understood. We believe that the serious skin toxicities that these patients develop when treated with concomitant cetuximab occur more frequently than when patients are treated with concurrent cisplatin.

• Retrospective review of HNC patients treated with concurrent cetuximab and radiation
• Patients treated in either definitive or loco-regionally recurrent setting with nonmetastatic disease who received their first dose of cetuximab from March 1, 2006 to January 1, 2008included
• 115 patients

• Serious radiation dermatitis noted in 26 (23%) patients (22 developed grade 3 dermatitis and 4 developed grade 4 dermatitis)
• 4 patients developed grade 4 dermatitis did so within radiation field
• Dermatitis manifested by spontaneous bleeding from involved skin, and in 1 case, skin necrosis
• Toxicities developed during fifth week of treatment

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