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International Journal of Clinical Oncology

Published in:

01-04-2014 | Original Article

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, Andrew M. Baschnagel, Peter Chen, Gregory Gustafson, Ishmael Jaiyesmi, Mitchell Folbe, Hong Ye, Jan Akervall, Daniel Krauss

Published in: International Journal of Clinical Oncology | Issue 2/2014

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.

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Title: 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
Andrew M. Baschnagel
Peter Chen
Gregory Gustafson
Ishmael Jaiyesmi
Mitchell Folbe
Hong Ye
Jan Akervall
Daniel Krauss
Publication date: 01-04-2014
Publisher: Springer Japan
Published in: International Journal of Clinical Oncology / Issue 2/2014
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-013-0540-y

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