Grading system and management guidelines for dermatitis induced by head and neck radiotherapy plus cetuximab: clinical validation required.

摘要

Head and neck squamous cell carcinoma (HNSCC) represents a rather heterogeneous group of neoplasms originating from the oral cavity, oropharynx, hypopharynx and larynx. In the last decades, prognosis significantly increased as a result of the introduction of new treatment strategies, such as the addition of concomitant chemotherapy to radiation [1], the use of altered fractionation schedules [2] and, more recently, the use of taxane-based induction chemotherapy [3, 4]. Although outcome in terms of locoregional control and overall survival (OS) are improved, most of these regimens have come to the expense of severe acute and late radiation-induced side-effects, such as mucositis and subsequent swallowing dysfunction. Despite the fact that there is still ample room for improvement, further intensification of concurrent chemoradiation regimens is expected to result in unacceptable acute toxicity rates. In this regard, there has been and will be a growing need for new combined modality strategies that improve treatment efficacy without enhancing radiation-induced side-effects.