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Cisplatin-based chemoradiotherapy vs. cetuximab-based bioradiotherapy for p16-positive oropharyngeal cancer: an updated meta-analysis including trials RTOG 1016 and De-ESCALaTE

European Archives of Oto-Rhino-Laryngology volume 276, pages 1275–1281 (2019)Cite this article

A Letter to Editor to this article was published on 25 April 2019

Abstract

Purpose

Human papilloma virus (HPV)-associated oropharyngeal cancer (OPC) is a special entity among head and neck squamous cell carcinomas (HNSCCs). Given its favorable prognosis, one of the de-escalating strategies in the treatment of OPC includes the introduction of cetuximab (C225) instead of cisplatin (CDDP) in conjunction with radiotherapy. An updated meta-analysis of published studies has been performed, which directly compared the efficacy of CDDP vs. C225 given concurrently with radiotherapy as definitive treatment of p16-positive OPC.

Methods

A systematic literature search was performed for studies published between 2006 and 2018. A total of 1490 citations were obtained and 8 studies met inclusion criteria, with a total of 1665 patients.

Results

The data from seven studies were available for the analysis of 2-year overall survival (OS). Calculated pooled OR for CDDP-based chemoradiotherapy vs. C225-based bioradiotherapy, was 0.45 (P < 0.0001). The data from eight studies were available for the analysis of 2-year locoregional recurrence (LRR). Calculated pooled OR for CDDP-based chemoradiotherapy vs. C225-based bioradiotherapy was 0.35 (P < 0.0001). Patients receiving CDDP with irradiation had 2.2- and 2.9-fold decreased risk for death from any cause and LRR, respectively.

Conclusions

For patients with HPV-positive OPC, radiotherapy plus C225 showed inferior OS and higher LRR rates compared with radiotherapy plus CDDP. CDDP-based chemoradiotherapy should remain standard of definitive treatment of p16-positive OPC.

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Authors and Affiliations

  1. Department of Radiotherapy and Medical Oncology, University Hospital for Tumors, University Hospital Centre “Sisters of Mercy”, Ilica 197, 10000, Zagreb, Croatia

    Petar Suton

  2. Pharmacy Department, General Hospital Sibenik, Stjepana Radica 83, Sibenik, Croatia

    Marko Skelin

  3. Department of Oncology, University of Zagreb School of Medicine, University Hospital Centre Zagreb, Kispaticeva 12, 10000, Zagreb, Croatia

    Zoran Rakusic

  4. Department of Traumatology and Orthopaedics, University Hospital Dubrava, Avenue Gojko Susak 6, 10000, Zagreb, Croatia

    Stjepan Dokuzovic

  5. Department of Maxillofacial Surgery, University of Zagreb School of Medicine, University Hospital Dubrava, Avenue Gojko Susak 6, 10000, Zagreb, Croatia

    Ivica Luksic

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  1. Petar Suton
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Correspondence to Petar Suton.

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Suton, P., Skelin, M., Rakusic, Z. et al. Cisplatin-based chemoradiotherapy vs. cetuximab-based bioradiotherapy for p16-positive oropharyngeal cancer: an updated meta-analysis including trials RTOG 1016 and De-ESCALaTE. Eur Arch Otorhinolaryngol 276, 1275–1281 (2019). https://doi.org/10.1007/s00405-019-05387-8

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  • DOI: https://doi.org/10.1007/s00405-019-05387-8

Keywords

  • Oropharyngeal cancer
  • Human papilloma virus
  • Cisplatin
  • Cetuximab
  • Survival
  • Recurrence