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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.
MedLine Citation:
PMID:  23479120     Owner:  NLM     Status:  Publisher    
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.
Jiayi Huang; Andrew M Baschnagel; Peter Chen; Gregory Gustafson; Ishmael Jaiyesmi; Mitchell Folbe; Hong Ye; Jan Akervall; Daniel Krauss
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-3-12
Journal Detail:
Title:  International journal of clinical oncology     Volume:  -     ISSN:  1437-7772     ISO Abbreviation:  Int. J. Clin. Oncol.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-3-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9616295     Medline TA:  Int J Clin Oncol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Radiation Oncology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
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