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

Authors

  • Jiayi Huang
    • Department of Radiation OncologyWashington University School of Medicine in St. Louis
  • Andrew M. Baschnagel
    • Department of Radiation Oncology, William Beaumont HospitalOakland University William Beaumont School of Medicine
  • Peter Chen
    • Department of Radiation Oncology, William Beaumont HospitalOakland University William Beaumont School of Medicine
  • Gregory Gustafson
    • Department of Radiation OncologyWilliam Beaumont Hospital
  • Ishmael Jaiyesmi
    • Division of Medical OncologyWilliam Beaumont Hospital
  • Mitchell Folbe
    • Division of Medical OncologyWilliam Beaumont Hospital
  • Hong Ye
    • Department of Radiation OncologyWilliam Beaumont Hospital
  • Jan Akervall
    • Department of SurgeryWilliam Beaumont Hospital
    • Department of Radiation Oncology, William Beaumont HospitalOakland University William Beaumont School of Medicine
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