open access

Vol 22, No 5 (2017)
Original research articles
Published online: 2017-09-01
Submitted: 2016-12-06
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A comparison of concurrent cisplatin versus cetuximab with radiotherapy in locally-advanced head and neck cancer: A bi-institutional analysis

William A. Stokes, Whitney A. Sumner, Kiersten L. Breggren, John T. Rathbun, David Raben, Jessica D. McDermott, Gregory Gan, Sana D. Karam
DOI: 10.1016/j.rpor.2017.07.003
·
Rep Pract Oncol Radiother 2017;22(5):389-395.

open access

Vol 22, No 5 (2017)
Original research articles
Published online: 2017-09-01
Submitted: 2016-12-06

Abstract

Aim

To present our experience comparing cisplatin- and cetuximab-based radiotherapy for locally-advanced head and neck squamous cell carcinoma.

Background

The comparative effectiveness of cisplatin-based chemoradiotherapy (CRT) versus cetuximab-based bioradiotherapy (BRT) for locally-advanced head and neck squamous cell carcinoma (LAHNSCC) continues to be explored.

Materials and methods

Outcomes of LAHNSCC patients treated with CRT (125) or BRT (34) at two institutions were compared retrospectively, with attention to overall survival (OS), cancer-specific survival (CSS), locoregional control (LRC), and distant control (DC). Univariate analysis (UVA) using Cox regression was performed to explore the association of intervention with survival and disease control, and multivariate (MVA) Cox regression was then performed to assess the association of intervention with survival.

Results

There were significant baseline differences between the CRT and BRT groups with respect to age, race, performance status, N-classification, tobacco history, and human papillomavirus status. UVA demonstrated inferiority of BRT versus CRT with respect to both OS (hazard ratio [HR] 2.19, 95% confidence interval [95%CI] 1.03–4.63, p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.04) and CSS (HR 3.33, 95%CI 1.42–7.78, p[[ce:hsp sp="0.25"/]]<[[ce:hsp sp="0.25"/]]0.01), but non-significantly different outcomes in LRC (HR 0.99, 95%CI 0.37–2.61, p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.98) and DC (HR 2.01, 95%CI 0.78–5.37, p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.14). On MVA, there was no significant OS difference between interventions (HR 1.19, 95%CI 0.42–3.35, p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.74); there were too few events for the other outcomes to draw meaningful conclusions with MVA.

Conclusions

In our retrospective analysis, patients undergoing CRT experienced improved OS and CSS over those receiving BRT; however, disease control did not significantly differ. These findings may inform management of LAHNSCC patients.

Abstract

Aim

To present our experience comparing cisplatin- and cetuximab-based radiotherapy for locally-advanced head and neck squamous cell carcinoma.

Background

The comparative effectiveness of cisplatin-based chemoradiotherapy (CRT) versus cetuximab-based bioradiotherapy (BRT) for locally-advanced head and neck squamous cell carcinoma (LAHNSCC) continues to be explored.

Materials and methods

Outcomes of LAHNSCC patients treated with CRT (125) or BRT (34) at two institutions were compared retrospectively, with attention to overall survival (OS), cancer-specific survival (CSS), locoregional control (LRC), and distant control (DC). Univariate analysis (UVA) using Cox regression was performed to explore the association of intervention with survival and disease control, and multivariate (MVA) Cox regression was then performed to assess the association of intervention with survival.

Results

There were significant baseline differences between the CRT and BRT groups with respect to age, race, performance status, N-classification, tobacco history, and human papillomavirus status. UVA demonstrated inferiority of BRT versus CRT with respect to both OS (hazard ratio [HR] 2.19, 95% confidence interval [95%CI] 1.03–4.63, p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.04) and CSS (HR 3.33, 95%CI 1.42–7.78, p[[ce:hsp sp="0.25"/]]<[[ce:hsp sp="0.25"/]]0.01), but non-significantly different outcomes in LRC (HR 0.99, 95%CI 0.37–2.61, p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.98) and DC (HR 2.01, 95%CI 0.78–5.37, p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.14). On MVA, there was no significant OS difference between interventions (HR 1.19, 95%CI 0.42–3.35, p[[ce:hsp sp="0.25"/]]=[[ce:hsp sp="0.25"/]]0.74); there were too few events for the other outcomes to draw meaningful conclusions with MVA.

Conclusions

In our retrospective analysis, patients undergoing CRT experienced improved OS and CSS over those receiving BRT; however, disease control did not significantly differ. These findings may inform management of LAHNSCC patients.

Get Citation

Keywords

Head and neck cancer; Chemoradiotherapy; Cisplatin; Cetuximab; Radiosensitization

About this article
Title

A comparison of concurrent cisplatin versus cetuximab with radiotherapy in locally-advanced head and neck cancer: A bi-institutional analysis

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 22, No 5 (2017)

Pages

389-395

Published online

2017-09-01

DOI

10.1016/j.rpor.2017.07.003

Bibliographic record

Rep Pract Oncol Radiother 2017;22(5):389-395.

Keywords

Head and neck cancer
Chemoradiotherapy
Cisplatin
Cetuximab
Radiosensitization

Authors

William A. Stokes
Whitney A. Sumner
Kiersten L. Breggren
John T. Rathbun
David Raben
Jessica D. McDermott
Gregory Gan
Sana D. Karam

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