Treatment patterns of targeted and nontargeted therapies and survival effects in patients with locally advanced head and neck cancer in Taiwan.

Autor: Hu SH; Master Program in Clinical Pharmacy, School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan., Huang MY; Department of Radiation Oncology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan., Chen CY; Master Program in Clinical Pharmacy, School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan.; Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.; Center for Big Data Research, Kaohsiung Medical University, Kaohsiung, Taiwan., Hsieh HM; Center for Big Data Research, Kaohsiung Medical University, Kaohsiung, Taiwan. hsiehhm@gmail.com.; Department of Public Health, Department of Medical Research, Department of Community Medicine, Research Center for Precision Environmental Medicine, Kaohsiung Medical University Hospital, 100 Shih-Chung 1st Road, San-Ming Dist, Kaohsiung, 807, Taiwan. hsiehhm@gmail.com.
Jazyk: angličtina
Zdroj: BMC cancer [BMC Cancer] 2023 Jun 20; Vol. 23 (1), pp. 567. Date of Electronic Publication: 2023 Jun 20.
DOI: 10.1186/s12885-023-11061-4
Abstrakt: Background: Taiwan's National Health Insurance has covered targeted therapy, namely cetuximab, for locally advanced head and neck cancers (LAHNC) since July 2009. This study examines treatment trends and survival effects of locally advanced head and neck cancer patients before and after Taiwan's National Health Insurance covered cetuximab.
Methods: We examined treatment trends and survival effects for patients with LAHNC using Taiwan's National Health Insurance Research Database. Patients who received treatment within 6 months were categorized as either nontargeted or targeted therapy groups. We analyzed treatment trends with the Cochran-Armitage trend test and explored factors associated with treatment selection and survival effects using multivariable logistic regression and Cox proportional hazards models.
Results: Of the 20,900 LAHNC patients included in the study, 19,696 received nontargeted therapy, while 1,204 received targeted therapy. Older patients with more comorbid conditions, advanced stages and patients with hypopharynx and oropharynx cancers were more likely to receive targeted therapy with concomitant cetuximab treatment. Patients who received targeted therapy in addition to other treatment modalities had a greater risk of one-year and long-term all-cause mortality or cancer-specific mortality than those without receiving targeted therapy (P < 0.001).
Conclusions: Our study found an increasing trend in cetuximab utilization among LAHNC after reimbursement in Taiwan, but overall usage rates were low. LAHNC patients receiving cetuximab with other treatments had higher mortality risk than those receiving cisplatin, suggesting cisplatin may be preferred. Further research is needed to identify subgroups that could benefit from concomitant cetuximab treatment.
(© 2023. The Author(s).)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje