| Autor: |
Hecht M; Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany.; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), 91054 Erlangen, Germany.; Deutsches Zentrum Immuntherapie (DZI), Universitätsklinikum Erlangen, 91054 Erlangen, Germany., Hahn D; Klinikum Stuttgart, Klinik für Onkologie, 70173 Stuttgart, Germany., Wolber P; Klinik für Hals-, Nasen-und Ohrenheilkunde, Universitätsklinikum Köln, 50935 Köln, Germany., Hautmann MG; Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Regensburg, 93053 Regensburg, Germany., Reichert D; Medizinische Studiengesellschaft NORD-WEST GmbH, 26655 Westerstede, Germany., Weniger S; Gemeinschaftspraxis Dres. Weniger/Bittrich, 99085 Erfurt, Germany., Belka C; Klinikum der Universität München (A.ö.R.), Klinik für Strahlentherapie und Radioonkologie, 81377 München, Germany., Bergmann T; SRH Wald-Klinikum Gera GmbH, II. Medizinische Klinik, 07548 Gera, Germany., Göhler T; Onkozentrum Dresden/Freiburg, 01127 Dresden, Germany., Welslau M; Klinikum Aschaffenburg, Hämato-Onkologische Schwerpunktpraxis, 63739 Aschaffenburg, Germany., Große-Thie C; Zentrum Innere Medizin Klinik III-Hämatologie, Onkologie, Palliativmedizin, Universitätsmedizin Rostock, 18057 Rostock, Germany., Guntinas-Lichius O; Klinik für Hals-, Nasen-und Ohrenheilkunde, Universitätsklinikum Jena, 07747 Jena, Germany., von der Grün J; Klinik für Strahlentherapie und Onkologie, Klinikum der J.-W. Goethe-Universität Frankfurt a.M., 60596 Frankfurt, Germany., Balermpas P; Klinik für Strahlentherapie und Onkologie, Klinikum der J.-W. Goethe-Universität Frankfurt a.M., 60596 Frankfurt, Germany., Orlowski K; Merck Serono GmbH, Medical Affairs Oncology, 94293 Darmstadt, Germany., Messinger D; Prometris GmbH, 68219 Mannheim, Germany., Stenzel KG; Merck Serono GmbH, Medical Affairs Oncology, 94293 Darmstadt, Germany., Fietkau R; Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany.; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), 91054 Erlangen, Germany.; Deutsches Zentrum Immuntherapie (DZI), Universitätsklinikum Erlangen, 91054 Erlangen, Germany. |
| Abstrakt: |
Treatment options of locoregional recurrent head and neck squamous cell cancer (HNSCC) include both local strategies as surgery or re-radiotherapy and systemic therapy. In this prospective, multi-center, non-interventional study, patients were treated either with platinum-based chemotherapy and cetuximab (CT + Cet) or re-radiotherapy and cetuximab (RT + Cet). In the current analysis, progression-free survival (PFS) and overall survival (OS) were compared in patients with locoregional recurrence. Four hundred seventy patients were registered in 97 German centers. After exclusion of patients with distant metastases, a cohort of 192 patients was analyzed (129 CT + Cet, 63 RT + Cet). Radiotherapy was delivered as re-irradiation to 70% of the patients. The mean radiation dose was 51.8 Gy, whereas a radiation dose of ≥60 Gy was delivered in 33% of the patients. Chemotherapy mainly consisted of cisplatin/5-flurouracil (40%) or carboplatin/5-flurouracil (29%). The median PFS was 9.2 months in the RT + Cet group versus 5.1 months in the CT + Cet group (hazard ratio for disease progression or death, 0.40, 95% CI, 0.27-0.57, p < 0.0001). Median OS was 12.8 months in the RT + Cet group versus 7.9 months in the CT + Cet group (hazard ratio for death, 0.50, 95% CI, 0.33-0.75, p = 0.0008). In conclusion, radiotherapy combined with cetuximab improved survival compared to chemotherapy combined with cetuximab in locally recurrent HNSCC. |
