International Journal of Clinical Oncology

, Volume 19, Issue 2, pp 240–246

A matched-pair comparison of intensity-modulated radiation therapy with cetuximab versus intensity-modulated radiation therapy with platinum-based chemotherapy for locally advanced head neck cancer

  • Jiayi Huang
  • Andrew M. Baschnagel
  • Peter Chen
  • Gregory Gustafson
  • Ishmael Jaiyesmi
  • Mitchell Folbe
  • Hong Ye
  • Jan Akervall
  • Daniel Krauss
Original Article

DOI: 10.1007/s10147-013-0540-y

Cite this article as:
Huang, J., Baschnagel, A.M., Chen, P. et al. Int J Clin Oncol (2014) 19: 240. doi:10.1007/s10147-013-0540-y

Abstract

Purpose

We retrospectively compared the efficacy of intensity-modulated radiotherapy (IMRT) and cetuximab (IMRT/cetuximab) versus IMRT and platinum-based chemotherapy (IMRT/platinum) for locally advanced head neck squamous cell carcinoma (LAHNSCC).

Methods

Thirty-one IMRT/cetuximab patients were matched 1:2 with 62 IMRT/platinum patients according to primary site and clinical stage. The primary endpoint was locoregional recurrence (LRR), and secondary endpoints included distant metastasis (DM), cause-specific survival (CSS), and overall survival (OS).

Results

Because of inherent selection bias, the IMRT/cetuximab cohort was significantly older and with a higher Charlson Comorbidity Index. IMRT/cetuximab and IMRT/platinum did not have significantly different LRR and DM (33 vs. 23 % at 2 years, P = 0.22; 17 vs. 11 % at 2 years, P = 0.40; respectively). IMRT/cetuximab had significantly worse CSS and OS (67 vs. 84 %, P = 0.04; 58 vs. 83 %, P = 0.001; respectively). However, for the subset of elderly patients ≥65 years old, there is no difference between the two cohorts for all endpoints (all P = NS).

Conclusion

IMRT/platinum should remain the preferred choice of chemoradiotherapy for LAHNSCC, but IMRT/cetuximab may be a reasonable alternative for elderly patients.

Keywords

Head neck cancerChemoradiotherapy, cetuximabCisplatinIMRT

Copyright information

© Japan Society of Clinical Oncology 2013

Authors and Affiliations

  • Jiayi Huang
    • 1
  • Andrew M. Baschnagel
    • 2
  • Peter Chen
    • 2
  • Gregory Gustafson
    • 3
  • Ishmael Jaiyesmi
    • 4
  • Mitchell Folbe
    • 5
  • Hong Ye
    • 6
  • Jan Akervall
    • 7
  • Daniel Krauss
    • 2
  1. 1.Department of Radiation OncologyWashington University School of Medicine in St. LouisSt. LouisUSA
  2. 2.Department of Radiation Oncology, William Beaumont HospitalOakland University William Beaumont School of MedicineRoyal OakUSA
  3. 3.Department of Radiation OncologyWilliam Beaumont HospitalTroyUSA
  4. 4.Division of Medical OncologyWilliam Beaumont HospitalRoyal OakUSA
  5. 5.Division of Medical OncologyWilliam Beaumont HospitalTroyUSA
  6. 6.Department of Radiation OncologyWilliam Beaumont HospitalRoyal OakUSA
  7. 7.Department of SurgeryWilliam Beaumont HospitalRoyal OakUSA