Prognostic significance of p16 in locoregionally advanced head and neck cancer treated with concurrent 5-fluorouracil, hydroxyurea, cetuximab and intensity-modulated radiation therapy

  • Authors:
    • Charles C.L. Tong
    • K. H. Vincent Lau
    • Michael Rivera
    • David Cannan
    • Julio Aguirre-Ghiso
    • Andrew G. Sikora
    • Vishal Gupta
    • Kevin Forsythe
    • Eric C. Ko
    • Krzysztof Misiukiewicz
    • Vivek Gurudutt
    • Marita S. Teng
    • Stuart H. Packer
    • Eric M. Genden
    • Johnny Kao
  • View Affiliations

  • Published online on: February 7, 2012     https://doi.org/10.3892/or.2012.1679
  • Pages: 1580-1586
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Abstract

A phase II trial was conducted to evaluate the tolerability and efficacy of incorporating cetuximab and simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT) into a well-described 5-fluorouracil (5-FU) and hydroxyurea (HU)-based chemoradiation regimen. Patients with stage IVa-IVb or high-risk stage III squamous cell carcinomas were enrolled. Prior organ-conserving surgery or induction chemotherapy was allowed. IMRT was administered in 1.5 Gy fractions twice daily on days 1-5 of weeks 1, 3, 5, 7 ± 9 for a total dose of 60-73.5 Gy. Concurrent systemic therapy consisted of 5-FU (600 mg/m2), HU (500 mg BID) and cetuximab (250 mg/m2). p16INK4A expression was assessed by immunohistochemistry. From January 2007 to January 2010, 65 patients (61 with stage IV disease; 31 with oropharyngeal primaries) were enrolled. At a median follow-up of 28 months, 2-year locoregional control, distant control, progression-free survival, event-free survival and overall survival were 79, 83, 72, 63 and 80%, respectively. In 48 patients with available pre-treatment tissue, p16 overexpression was associated with significantly increased distant control (p=0.03), progression-free survival (p=0.02), event-free survival (p=0.007) and overall survival (p=0.03). The most common grade 3-4 toxicities were mucositis (46%), leukopenia (18%), anemia (18%) and dermatitis (17%). Concurrent 5-FU, HU, cetuximab and SIB-IMRT is a highly active regimen, particularly in patients with p16-positive disease.

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May 2012
Volume 27 Issue 5

Print ISSN: 1021-335X
Online ISSN:1791-2431

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Spandidos Publications style
Tong CC, Lau KH, Rivera M, Cannan D, Aguirre-Ghiso J, Sikora AG, Gupta V, Forsythe K, Ko EC, Misiukiewicz K, Misiukiewicz K, et al: Prognostic significance of p16 in locoregionally advanced head and neck cancer treated with concurrent 5-fluorouracil, hydroxyurea, cetuximab and intensity-modulated radiation therapy. Oncol Rep 27: 1580-1586, 2012
APA
Tong, C.C., Lau, K.H., Rivera, M., Cannan, D., Aguirre-Ghiso, J., Sikora, A.G. ... Kao, J. (2012). Prognostic significance of p16 in locoregionally advanced head and neck cancer treated with concurrent 5-fluorouracil, hydroxyurea, cetuximab and intensity-modulated radiation therapy. Oncology Reports, 27, 1580-1586. https://doi.org/10.3892/or.2012.1679
MLA
Tong, C. C., Lau, K. H., Rivera, M., Cannan, D., Aguirre-Ghiso, J., Sikora, A. G., Gupta, V., Forsythe, K., Ko, E. C., Misiukiewicz, K., Gurudutt, V., Teng, M. S., Packer, S. H., Genden, E. M., Kao, J."Prognostic significance of p16 in locoregionally advanced head and neck cancer treated with concurrent 5-fluorouracil, hydroxyurea, cetuximab and intensity-modulated radiation therapy". Oncology Reports 27.5 (2012): 1580-1586.
Chicago
Tong, C. C., Lau, K. H., Rivera, M., Cannan, D., Aguirre-Ghiso, J., Sikora, A. G., Gupta, V., Forsythe, K., Ko, E. C., Misiukiewicz, K., Gurudutt, V., Teng, M. S., Packer, S. H., Genden, E. M., Kao, J."Prognostic significance of p16 in locoregionally advanced head and neck cancer treated with concurrent 5-fluorouracil, hydroxyurea, cetuximab and intensity-modulated radiation therapy". Oncology Reports 27, no. 5 (2012): 1580-1586. https://doi.org/10.3892/or.2012.1679