A matched-pair comparison of intensity-modulated radiation therapy with cetuximab versus intensity-modulated radiation therapy with platinum-based chemotherapy for locally advanced head neck cancer.

Abstract

PURPOSE:

We retrospectively compared the efficacy of intensity-modulated radiotherapy (IMRT) and cetuximab (IMRT/cetuximab) versus IMRT and platinum-based chemotherapy (IMRT/platinum) for locally advanced head neck squamous cell carcinoma (LAHNSCC).

METHODS:

Thirty-one IMRT/cetuximab patients were matched 1:2 with 62 IMRT/platinum patients according to primary site and clinical stage. The primary endpoint was locoregional recurrence (LRR), and secondary endpoints included distant metastasis (DM), cause-specific survival (CSS), and overall survival (OS).

RESULTS:

Because of inherent selection bias, the IMRT/cetuximab cohort was significantly older and with a higher Charlson Comorbidity Index. IMRT/cetuximab and IMRT/platinum did not have significantly different LRR and DM (33 vs. 23 % at 2 years, P = 0.22; 17 vs. 11 % at 2 years, P = 0.40; respectively). IMRT/cetuximab had significantly worse CSS and OS (67 vs. 84 %, P = 0.04; 58 vs. 83 %, P = 0.001; respectively). However, for the subset of elderly patients ≥65 years old, there is no difference between the two cohorts for all endpoints (all P = NS).

CONCLUSION:

IMRT/platinum should remain the preferred choice of chemoradiotherapy for LAHNSCC, but IMRT/cetuximab may be a reasonable alternative for elderly patients.

• Authors: Jiayi Huang, Andrew M Baschnagel, Peter Chen, Gregory Gustafson, Ishmael Jaiyesmi, Mitchell Folbe, Hong Ye, Jan Akervall, Daniel Krauss
• Journal: International journal of clinical oncology (Int J Clin Oncol) Vol. 19 Issue 2 Pg. 240-6 (Apr 2014) ISSN: 1437-7772 [Electronic] Japan
• PMID: 23479120 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Antibodies, Monoclonal, Humanized
• Antineoplastic Agents
• Cetuximab
• Cisplatin

Topics

• Adult
• Aged
• Aged, 80 and over
• Antibodies, Monoclonal, Humanized (administration & dosage)
• Antineoplastic Agents (therapeutic use)
• Carcinoma, Squamous Cell (mortality, therapy)
• Cetuximab
• Chemoradiotherapy (methods)
• Cisplatin (administration & dosage)
• Female
• Head and Neck Neoplasms (mortality, therapy)
• Humans
• Male
• Matched-Pair Analysis
• Middle Aged
• Radiotherapy, Intensity-Modulated (methods)
• Retrospective Studies
• Squamous Cell Carcinoma of Head and Neck