Lauren Q Shapiro1, Eric J Sherman2, Nadeem Riaz1, Jeremy Setton1, Lawrence Koutcher1, Zhigang Zhang3, Weiji Shi3, Matthew G Fury2, Suzanne L Wolden1, David G Pfister2, Luc Morris4, Nancy Lee5. 1. Memorial Sloan-Kettering Cancer Center, Department of Radiation Oncology, New York, NY, United States. 2. Memorial Sloan-Kettering Cancer Center, Department of Medicine, New York, NY, United States. 3. Memorial Sloan-Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York, NY, United States. 4. Memorial Sloan-Kettering Cancer Center, Department of Surgery, New York, NY, United States. 5. Memorial Sloan-Kettering Cancer Center, Department of Radiation Oncology, New York, NY, United States. Electronic address: leen2@mskcc.org.
Abstract
OBJECTIVES: We previously reported inferior outcomes for locally-advanced head and neck squamous cell carcinoma (LAHNSCC) patients treated with concurrent cetuximab vs. high-dose cisplatin with intensity-modulated radiation therapy (IMRT). Prior to FDA approval of cetuximab for LAHNSCC, non-cisplatin eligible patients at our institution received 5-fluorouracil (5FU)/carboplatin. We sought to compare concurrent cetuximab vs. 5FU/carboplatin vs. high-dose cisplatin with IMRT for LAHNSCC. MATERIALS AND METHODS: Retrospective review was performed for LAHNSCC patients treated at Memorial Sloan-Kettering Cancer Center from 11/02 to 04/08 with concurrent cetuximab (n=49), 5FU/carboplatin (n=52), or cisplatin (n=259) and IMRT. Overall survival (OS), locoregional failure (LRF), distant metastasis-free survival, and late toxicity were analyzed using univariate and multivariate analyses. OS analysis was confirmed by propensity score adjustment. RESULTS: Treatment groups were similar with regard to primary tumor site, overall stage, and alcohol and tobacco history. Cetuximab and 5FU/carboplatin patients were older, with lower performance status, more comorbidities, higher T classification, and worse renal function. On multivariate analysis, compared with cisplatin and 5FU/carboplatin, cetuximab was associated with inferior 4-year OS (86.9% vs. 70.2% vs. 40.9%; P<.0001) and 4-year LRF (6.3% vs. 9.7% vs. 40.2%; P<.0001). Late toxicity was highest with 5FU/carboplatin (25.0%) vs. cisplatin (8.0%) vs. cetuximab (7.7%). CONCLUSIONS: Although 5FU/carboplatin patients were sicker and experienced greater toxicity than cisplatin patients, no significant difference was found in all endpoints. In contrast, despite similar pretreatment characteristics, outcomes for cetuximab vs. 5FU/carboplatin were significantly worse. We feel that caution should be used with routine use of cetuximab in the management of LAHNSCC.
OBJECTIVES: We previously reported inferior outcomes for locally-advanced head and neck squamous cell carcinoma (LAHNSCC) patients treated with concurrent cetuximab vs. high-dose cisplatin with intensity-modulated radiation therapy (IMRT). Prior to FDA approval of cetuximab for LAHNSCC, non-cisplatin eligible patients at our institution received 5-fluorouracil (5FU)/carboplatin. We sought to compare concurrent cetuximab vs. 5FU/carboplatin vs. high-dose cisplatin with IMRT for LAHNSCC. MATERIALS AND METHODS: Retrospective review was performed for LAHNSCC patients treated at Memorial Sloan-Kettering Cancer Center from 11/02 to 04/08 with concurrent cetuximab (n=49), 5FU/carboplatin (n=52), or cisplatin (n=259) and IMRT. Overall survival (OS), locoregional failure (LRF), distant metastasis-free survival, and late toxicity were analyzed using univariate and multivariate analyses. OS analysis was confirmed by propensity score adjustment. RESULTS: Treatment groups were similar with regard to primary tumor site, overall stage, and alcohol and tobacco history. Cetuximab and 5FU/carboplatinpatients were older, with lower performance status, more comorbidities, higher T classification, and worse renal function. On multivariate analysis, compared with cisplatin and 5FU/carboplatin, cetuximab was associated with inferior 4-year OS (86.9% vs. 70.2% vs. 40.9%; P<.0001) and 4-year LRF (6.3% vs. 9.7% vs. 40.2%; P<.0001). Late toxicity was highest with 5FU/carboplatin (25.0%) vs. cisplatin (8.0%) vs. cetuximab (7.7%). CONCLUSIONS: Although 5FU/carboplatinpatients were sicker and experienced greater toxicity than cisplatinpatients, no significant difference was found in all endpoints. In contrast, despite similar pretreatment characteristics, outcomes for cetuximab vs. 5FU/carboplatin were significantly worse. We feel that caution should be used with routine use of cetuximab in the management of LAHNSCC.
Authors: G Calais; M Alfonsi; E Bardet; C Sire; T Germain; P Bergerot; B Rhein; J Tortochaux; P Oudinot; P Bertrand Journal: J Natl Cancer Inst Date: 1999-12-15 Impact factor: 13.506
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Authors: B Singh; M Bhaya; J Stern; J T Roland; M Zimbler; R M Rosenfeld; G Har-El; F E Lucente Journal: Laryngoscope Date: 1997-11 Impact factor: 3.325
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