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

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

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

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.

Original languageEnglish
Pages (from-to)240-246
Number of pages7
JournalInternational Journal of Clinical Oncology
Volume19
Issue number2
DOIs
StatePublished - Apr 2014

Keywords

  • Chemoradiotherapy, cetuximab
  • Cisplatin
  • Head neck cancer
  • IMRT

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