Peddi Prakash, Shi Runhua, Nair Binu, Ampil Fred, Mills Glenn M, Jafri Syed H
Department of Medicine, Division of Hematology/Oncology, Louisiana State University Health, Shreveport, LA, USA. ; Feist-Weiller Cancer Center, Shreveport, LA, USA.
Department of Internal Medicine, Division of Oncology, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Clin Med Insights Oncol. 2015 Jan 4;9:1-7. doi: 10.4137/CMO.S18682. eCollection 2015.
Efficacy of cisplatin versus cetuximab with radiation in locally advanced head and neck cancer (LAHNC) was evaluated. A total of 96 patients with newly diagnosed LAHNC treated at our institution between 2006 and 2011 with concurrent radiation and cisplatin (group A, n = 45), cetuximab (group B, n = 24), or started with cisplatin but switched to cetuximab because of toxicity (group C, n = 27) were reviewed. Chi-square test, analysis of variance, and log-rank test were used for analysis. The three groups had similar baseline characteristics, except for median age, T stage, albumin levels, hemoglobin levels, performance status, and comorbidities. A complete response (CR) was seen in 77%, 17%, and 67% of patients (P < 0.001), respectively. There was no significant difference in median overall survival (OS) between groups A and C. The median OS for groups A and C was not reached (>65 months), even though it was significantly longer than median OS for group B (11.6 months; P ≤ 0.001). The 2-year OS in groups A and C is significantly higher than that in group B (70% for groups A and C, 22% for group B). There is no significant difference in progression-free survival (PFS) between groups A and C. The median PFS for these groups was not reached (>62 months), and is significantly longer than that for group B (4.3 months; P ≤ 0.001). The 2-year PFS of group A (67%) and group C (76%) was significantly longer than that of group B (20%). Cisplatin with radiation appears to be more efficacious even in suboptimal dosing than cetuximab with radiation in LAHNC but the two groups were not well matched.
评估了顺铂与西妥昔单抗联合放疗在局部晚期头颈癌（LAHNC）中的疗效。回顾了2006年至2011年间在本机构接受治疗的96例新诊断的LAHNC患者，这些患者接受了同步放疗和顺铂（A组，n = 45）、西妥昔单抗（B组，n = 24）治疗，或开始使用顺铂但因毒性改为西妥昔单抗（C组，n = 27）。采用卡方检验、方差分析和对数秩检验进行分析。除中位年龄、T分期、白蛋白水平、血红蛋白水平、体能状态和合并症外，三组的基线特征相似。三组患者的完全缓解（CR）率分别为77%、17%和67%（P < 0.001）。A组和C组的中位总生存期（OS）无显著差异。A组和C组的中位OS未达到（>65个月），尽管明显长于B组的中位OS（11.6个月；P≤0.001）。A组和C组的2年总生存率显著高于B组（A组和C组为70%，B组为22%）。A组和C组的无进展生存期（PFS）无显著差异。这些组的中位PFS未达到（>62个月），且明显长于B组（4.3个月；P≤0.001）。A组（67%）和C组（76%）的2年无进展生存率显著长于B组（20%）。在LAHNC中，即使是次优剂量的顺铂联合放疗似乎也比西妥昔单抗联合放疗更有效，但两组的匹配性不佳。
