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老年头颈癌患者放化疗使用趋势:西妥昔单抗改变治疗模式

Trends in chemoradiation use in elderly patients with head and neck cancer: Changing treatment patterns with cetuximab.

作者信息

Baxi Shrujal S, O'Neill Caitriona, Sherman Eric J, Atoria Coral L, Lee Nancy Y, Pfister David G, Elkin Elena B

机构信息

Head and Neck Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.

Department of Medicine, Weill Medical College of Cornell University, New York, New York.

出版信息

Head Neck. 2016 Apr;38 Suppl 1(Suppl 1):E165-71. doi: 10.1002/hed.23961. Epub 2015 Jun 26.

Abstract

BACKGROUND

Cetuximab was approved for use in chemoradiation therapy (CRT) for locally advanced head and neck squamous cell carcinoma (HNSCC) in 2006.

METHODS

Among 3705 patients with locally advanced HNSCC identified in the linked Surveillance Epidemiology and End Results (SEER) Medicare database, we assessed treatment trends, including surgery, radiation therapy (RT), CRT, and specific agents used in CRT. We examined the influence of demographic and clinical characteristics on the likelihood of receiving CRT before and after 2006.

RESULTS

Chemoradiation use increased from 29% of patients diagnosed in 2001 to 61% in 2009 (p < .0001). Compared to before 2006, neither age nor comorbidity score was associated with receipt of CRT after 2006. Platinum combinations were the most commonly used concurrent chemotherapies before 2006, but, since then, cetuximab has become the most commonly used agent.

CONCLUSION

The use of CRT has increased substantially and cetuximab may have increased CRT use, especially in older and sicker patients. © 2015 Wiley Periodicals, Inc. Head Neck 38: E165-E171, 2016.

摘要

背景

西妥昔单抗于2006年被批准用于局部晚期头颈部鳞状细胞癌(HNSCC)的放化疗(CRT)。

方法

在通过关联监测、流行病学和最终结果(SEER)医疗保险数据库确定的3705例局部晚期HNSCC患者中,我们评估了治疗趋势,包括手术、放射治疗(RT)、CRT以及CRT中使用的特定药物。我们研究了人口统计学和临床特征对2006年前后接受CRT可能性的影响。

结果

放化疗的使用从2001年诊断患者的29%增加到2009年的61%(p < 0.0001)。与2006年之前相比,2006年之后年龄和合并症评分均与接受CRT无关。铂类联合化疗是2006年之前最常用的同步化疗方案,但自那时以来,西妥昔单抗已成为最常用的药物。

结论

CRT的使用大幅增加,西妥昔单抗可能增加了CRT的使用,尤其是在老年和病情较重的患者中。© 2015威利期刊公司。《头颈》38: E165 - E171, 2016。

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