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Chemotherapy for primary cancer can reduce the risk of head and neck second primary malignancy: a propensity-matched analysis

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Abstract

Objectives

To investigate the effect of chemotherapy versus no chemotherapy on the risk of second primary head and neck malignancies (SPHNMs) in patients with locally advanced oral squamous cell carcinoma (OSCC) and to assess the survival outcomes of patients with SPHNM.

Materials and methods

A total of 937 OSCC patients were divided into chemotherapy and nonchemotherapy groups by propensity score matching (PSM). In the presence of the competing event of non-SPHNM death, the fine and gray modified Cox proportional hazard model was fitted to detect the impact of various factors, including the history of chemotherapy, on SPHNM risk. The Kaplan–Meier method was used to assess the survival outcomes of patients.

Results

After PSM, the 10-year cumulative probability of SPHNM was 10.7% for patients who received chemotherapy and 22.1% for patients who did not. The fine and gray regression model showed that prior chemotherapy was associated with a 51% reduced risk of SPHNM (adjusted subdistribution hazard ratio (sHR): 0.49, 95% confidence interval (CI): 0.29–0.84, P = 0.1). The disease-free survival (DFS) rates did not differ significantly between the SPHNM and non-SPHNM groups. And there were no significant differences in DFS rates between the patients with and those without prior chemotherapy in the SPHNM group.

Conclusions

Chemotherapy for locally advanced primary OSCC is associated with a decreased incidence of subsequent SPHNM. However, chemotherapy for the primary cancer does not improve DFS in patients with SPHNM.

Clinical relevance

Chemotherapy plays a positive role in preventing SPHNMs for patients with oral squamous cell carcinoma.

Clinical trial registration

Before January 2015, the data were retrieved retrospectively, while after January 2015, the data were collected prospectively in a POROMS database (ClinicalTrials.gov ID: NCT02395367).

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Funding

This work was supported by the Capital’s Funds for Health Improvement and Research (CFH2020-2–2143), the National Natural Science Foundation of China (82072984), the Project of Beijing Municipal Education Commission (KM202110025008), and the Beijing Science and Technology Commission (Z161100000516201).

Author information

Author notes

  1. Lei Xiong and Huajiao Yu equally contributed to this research and are considered co-first authors.

Authors and Affiliations

  1. Department of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, No. 4 Tian Tan Xi Li, Dongcheng District, Beijing, 100050, People’s Republic of China

    Lei Xiong, Huajiao Yu, Chong Wang, Bo Li, Huan Liu, Aoming Cheng, Delong Li, Zhengxue Han & Zhien Feng

  2. Department of Stomatology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010050, People’s Republic of China

    Huajiao Yu

  3. Clinical Epidemiology and EBM Unit, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People’s Republic of China

    Wei Wei

Authors
  1. Lei Xiong
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  2. Huajiao Yu
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Corresponding author

Correspondence to Zhien Feng.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the Declaration of Helsinki of 1964 and its subsequent changes or comparable ethical standards. The study was approved by the Institutional Review Board of the Beijing Stomatological Hospital (CMUSH-IRB-KJ-PJ-2022-38).

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Xiong, L., Yu, H., Wei, W. et al. Chemotherapy for primary cancer can reduce the risk of head and neck second primary malignancy: a propensity-matched analysis. Clin Oral Invest 27, 571–580 (2023). https://doi.org/10.1007/s00784-022-04752-y

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  • DOI: https://doi.org/10.1007/s00784-022-04752-y

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