Division of Medical Oncology, Washington University School of Medicine, St. Louis, Mo., USA.
Oncology. 2013;85(5):290-6. doi: 10.1159/000355194. Epub 2013 Nov 6.
Whether or not cisplatin and cetuximab are similarly effective in improving outcomes when added to radiation therapy (RT) in squamous cell carcinoma of the head and neck is unknown.
Retrospective analysis was performed of patients treated with definitive RT and cisplatin (n = 18) or cetuximab (n = 29).
T and N classifications, stage, human papillomavirus status and smoking history were balanced in the two groups; however, patients in the cisplatin group were younger and had a better performance status. Delivery of RT was similar between the two groups. Median follow-up was 23 (4-64) months. Disease-specific survival (DSS) at 3 years was 83% in the cisplatin group and 31% in the cetuximab group. Recurrent disease was more common in the cetuximab group compared with the cisplatin group (17 vs. 4 patients). Propensity score analysis to adjust for differences in patient characteristics which influenced treatment selection showed that DSS was indeed longer with cisplatin than with cetuximab (DSS hazard ratio 0.15, confidence interval 0.033, 0.66; p = 0.012).
DSS was superior in the patients given cisplatin with definitive RT compared to cetuximab with definitive RT due to a lower risk of recurrent disease in the cisplatin group. These observations could not be explained by differences between the two groups in the patient and tumor characteristics or in treatment delivery.
顺铂和西妥昔单抗联合放疗（RT）是否同样能改善头颈部鳞状细胞癌的预后尚不清楚。
对接受根治性 RT 联合顺铂（n=18）或西妥昔单抗（n=29）治疗的患者进行回顾性分析。
两组患者的 T 期和 N 期、分期、人乳头瘤病毒状态和吸烟史均均衡；然而，顺铂组患者更年轻，功能状态更好。两组 RT 治疗方式相似。中位随访时间为 23（4-64）个月。顺铂组 3 年疾病特异性生存率（DSS）为 83%，西妥昔单抗组为 31%。西妥昔单抗组的复发病例比顺铂组更常见（17 例比 4 例）。采用倾向评分分析调整影响治疗选择的患者特征差异后，发现顺铂治疗的 DSS 确实长于西妥昔单抗（DSS 风险比 0.15，置信区间 0.033，0.66；p=0.012）。
由于顺铂组复发风险较低，与接受根治性 RT 联合西妥昔单抗的患者相比，接受根治性 RT 联合顺铂的患者的 DSS 更高。这些观察结果不能用两组患者和肿瘤特征或治疗方式的差异来解释。
