2017 Volume 77 Issue 1 Pages 96-100
Cetuximab is a molecular-targeted therapy for human epidermal growth factor receptor. Approval of the application to the head and neck cancer has become a choice for a new treatment since it was made available in December 2012. With respect to the adverse events of cetuximab, acneiform eruption, infusion reactions and interstitial pneumonia are well known, but there are few reports of the expression of bone marrow suppression. Here, we recommend cetuximab combination radiation therapy for hypopharynx cancer. We report a case that with neutropenia （Grade4）. The patient was 63-year-old man who was brought to our center for examination of a left neck mass. Upon close examination, he was diagnosed with hypopharyngeal cancer （cT1N2aM0）. Because anemia （Hb6.9g/dl） was recognized prior to treatment, it was determined that he receive the cetuximab combination radiation therapy. Cetuximab is administered every week once a week; the first dose of cetuximab is 400mg/m2, in the second and subsequent weeks 250mg/m2 is given. Here it was administered a total of six times and the admitted adverse events were acneiform eruption （Grade2） and mucositis （Grade2） during the course of treatment. Four days after the final administration, the neutrophils were decreased to 500/mm3; G-CSF formulation was administered and neutrophils were reduced to 210/mm3 on the following day （Grade4）. Thereafter, G-CSF formulation was administered 7 days and neutrophils were improved to 5,700/mm3.
