Combination of post-operative radiotherapy and cetuximab for high-risk cutaneous squamous cell cancer of the head and neck: A propensity score analysis.

Autor: Palmer JD; Department of Radiation Oncology, The James Cancer Hospital at The Ohio State University, Columbus, OH, United States., Schneider CJ; Department of Medical Oncology, Helen F. Graham Cancer Center, Christiana Care Health System, Newark, DE, United States., Hockstein N; Section of Otolaryngology - Head and Neck Surgery, Department of Surgery, Helen F. Graham Cancer Center, Christiana Care Health System, Newark, DE, United States., Hanlon AL; Department of Nursing, University of Pennsylvania, Philadelphia, PA, United States., Silberg J; Department of Radiation Oncology, The James Cancer Hospital at The Ohio State University, Columbus, OH, United States., Strasser J; Department of Radiation Oncology, Helen F. Graham Cancer Center, Christiana Care Health System, Newark, DE, United States., Mauer EA; Department of Nursing, University of Pennsylvania, Philadelphia, PA, United States., Dzeda M; Department of Radiation Oncology, Helen F. Graham Cancer Center, Christiana Care Health System, Newark, DE, United States., Witt R; Section of Otolaryngology - Head and Neck Surgery, Department of Surgery, Helen F. Graham Cancer Center, Christiana Care Health System, Newark, DE, United States., Raben A; Department of Radiation Oncology, Helen F. Graham Cancer Center, Christiana Care Health System, Newark, DE, United States. Electronic address: ARaben@christianacare.org.
Jazyk: angličtina
Zdroj: Oral oncology [Oral Oncol] 2018 Mar; Vol. 78, pp. 102-107. Date of Electronic Publication: 2018 Feb 20.
DOI: 10.1016/j.oraloncology.2018.01.015
Abstrakt: Objectives: The objective of this study was to investigate the safety, tolerability and preliminary efficacy of radiotherapy plus cetuximab in high risk CSCC patients.
Materials and Methods: Patients with high-risk CSCC diagnosed between 2006 and 2013 were analyzed. Patients were divided into two groups: radiotherapy alone versus radiotherapy plus cetuximab. Among 68 patients meeting study criteria, we identified 29 treated with cetuximab plus RT and 39 with RT alone. Primary analysis examined disease-free and overall survival, freedom from local and distant recurrence in the propensity score matched cohort. Propensity score analysis was performed with weighted factors including: Charlson Comorbidity Index score, age. KPS, primary location, T and N stage, recurrent status, margin status, LVSI, PNI and grade. Toxicity was assessed using the CTCAE v4.0.
Results: Median follow-up for living patients was 30 months. Patients in the cetuximab group were more likely to have advanced N stage, positive margins and recurrent disease. After propensity score matching the groups were well balanced. Six patients experienced ≥ grade 3 acute toxicity in the cetuximab group. The 1-year, 2-year and 5-year progression free survival (PFS) for patients in the cetuximab group were 86%, 72% and 66%, respectively. The 1-year, 2-year and 5-year overall survival (OS) for patients in the cetuximab group was 98%, 80% and 80%, respectively.
Conclusions: Although limited by small numbers, the combination of cetuximab and radiotherapy in CSCC appears well tolerated there were more long-term survivors and less distant metastasis in the cetuximab group. These promising finding warrant further studies.
(Copyright © 2018 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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