Recently it becomes clear that cetuximab with radiotherapy is useful for locoregionally advanced head and neck cancer. We have already experienced 5 cases. In our department, the indications for this treatment are those cases in which we cannot use CDDP because of renal insufficiency and advanced age, or where we cannot use CDDP more 200 mg/m².
Hypopharyngeal cancer was found in 2 of the 5 patients, and 1 case each was mesopharyngeal cancer, laryngeal cancer and cancer of unknown origin. The pathological diagnosis was SCC in all cases and most of them were at a very advanced N stage. In all cases we could not use CDDP because of renal insufficiency and a deteriorating Performance State. A complete response was achieved in 2 cases, partial response in 2 cases and stable disease in only 1. Major side effects were stomatitis and dermatitis, but a feeding tube was required in only 1 case. There was no infusion reaction in this study, but we could not complete the study because of severe side effects: interstitial pneumonia and pseudomembranous conjunctivitis. The rate of successful execution was 60%. There is some possibility that cetuximab with radiotherapy is available as well as chemoradiothrapy. However, because the severe side effects of stomatitis and pharyngitis occurred with furring, there is some possibility that interstitial pneumonia could occur, which is potentially fatal. We therefore have to investigate those side effects and the result of this treatment, before changing from CDDP to cetuximab.