TY - JOUR
T1 - Concurrent use of cisplatin or cetuximab with definitive radiotherapy for locally advanced head and neck squamous cell carcinomas
AU - Levy, Antonin
AU - Blanchard, Pierre
AU - Bellefqih, Sara
AU - Brahimi, Nacéra
AU - Guigay, Joël
AU - Janot, François
AU - Temam, Stéphane
AU - Bourhis, Jean
AU - Deutsch, Eric
AU - Daly-Schveitzer, Nicolas
AU - Tao, Yungan
PY - 2014/1/1
Y1 - 2014/1/1
N2 - Aim. The goal of the present work was to compare outcomes of definitive concurrent cisplatin-based chemoradiotherapy (CRT) with cetuximab-based bioradiotherapy (BRT) in locally advanced head-and-neck squamous cell carcinoma (HNSCC). Patients and methods. Between 2006 and 2012, 265 patients with locally advanced HNSCC were treated at our institution with CRT (n=194; 73%) with three cycles of cisplatin (100 mg/m2, every 3 weeks) or BRT (n=71; 27%) with weekly cetuximab. Patients receiving BRT had more pre-existing conditions (Charlson index ≥2) than the CRT group (p=0.005). Results. Median follow-up was 29 months. In all, 56% of patients treated with CRT received the planned three cycles (92% at least two cycles) and 79% patients treated with BRT received six cycles or more. The 2-year actuarial overall survival (OS) and progression-free survival (PFS) were 72% and 61%, respectively. In the multivariate analysis (MVA), T4 stage, N2-3 stage, smoking status (current smoker as compared with never smoker), and non-oropharyngeal locations predicted for OS, whereas BRT association with OS was of borderline significance (p=0.054). The 2-year actuarial locoregional control (LRC) and distant control (DC) rates were 73 and 79%, respectively. CRT was independently associated with an improved LRC (2-year LRC: 76% for CRT vs. 61% for BRT) and DC (2-year LRC: 81% for CRT vs. 68% for BRT) in comparison with BRT (p<0.001 and p=0.01 in the MVA). Subgroup analyses showed that T4 patients benefited significantly from CRT (vs. BRT) in LRC, while T1-3 did not. BRT patients had more G3-4 skin complications (p<0.001) and CRT patients had higher rates of feeding tube placement (p=0.006) and G3-4 gastrointestinal toxicities (p<0.001). Conclusion. This retrospective analysis showed a better LRC in locally advanced HNSCC treated by cisplatin-based CRT than cetuximab-based BRT, and a nonsignificant trend towards an improved OS.
AB - Aim. The goal of the present work was to compare outcomes of definitive concurrent cisplatin-based chemoradiotherapy (CRT) with cetuximab-based bioradiotherapy (BRT) in locally advanced head-and-neck squamous cell carcinoma (HNSCC). Patients and methods. Between 2006 and 2012, 265 patients with locally advanced HNSCC were treated at our institution with CRT (n=194; 73%) with three cycles of cisplatin (100 mg/m2, every 3 weeks) or BRT (n=71; 27%) with weekly cetuximab. Patients receiving BRT had more pre-existing conditions (Charlson index ≥2) than the CRT group (p=0.005). Results. Median follow-up was 29 months. In all, 56% of patients treated with CRT received the planned three cycles (92% at least two cycles) and 79% patients treated with BRT received six cycles or more. The 2-year actuarial overall survival (OS) and progression-free survival (PFS) were 72% and 61%, respectively. In the multivariate analysis (MVA), T4 stage, N2-3 stage, smoking status (current smoker as compared with never smoker), and non-oropharyngeal locations predicted for OS, whereas BRT association with OS was of borderline significance (p=0.054). The 2-year actuarial locoregional control (LRC) and distant control (DC) rates were 73 and 79%, respectively. CRT was independently associated with an improved LRC (2-year LRC: 76% for CRT vs. 61% for BRT) and DC (2-year LRC: 81% for CRT vs. 68% for BRT) in comparison with BRT (p<0.001 and p=0.01 in the MVA). Subgroup analyses showed that T4 patients benefited significantly from CRT (vs. BRT) in LRC, while T1-3 did not. BRT patients had more G3-4 skin complications (p<0.001) and CRT patients had higher rates of feeding tube placement (p=0.006) and G3-4 gastrointestinal toxicities (p<0.001). Conclusion. This retrospective analysis showed a better LRC in locally advanced HNSCC treated by cisplatin-based CRT than cetuximab-based BRT, and a nonsignificant trend towards an improved OS.
KW - Antibodies, monoclonal, humanized
KW - Chemoradiotherapy
KW - Epidermal growth factor receptor inhibitors
KW - Head-and-neck cancer
KW - Toxicity
UR - http://www.scopus.com/inward/record.url?scp=84906936402&partnerID=8YFLogxK
U2 - 10.1007/s00066-014-0626-0
DO - 10.1007/s00066-014-0626-0
M3 - Article
C2 - 24638267
AN - SCOPUS:84906936402
SN - 0179-7158
VL - 190
SP - 823
EP - 831
JO - Strahlentherapie und Onkologie
JF - Strahlentherapie und Onkologie
IS - 9
ER -