西妥昔单抗与术后放疗同步用于切除的头颈部高危鳞状细胞癌：单机构经验

Concurrent cetuximab and postoperative radiation in resected high-risk squamous cell carcinomas of the head and neck: A single-institution experience.

作者信息

Araki Daisuke, Redman Mary W, Martins Renato, Eaton Keith, Baik Christina, Chow Laura, Goulart Bernardo, Lee Sylvia, Santana-Davila Rafael, Liao Jay, Parvathaneni Upendra, Laramore George, Futran Neal, Mendez Eduardo, Bhrany Amit, Rodriguez Cristina P

机构信息

Department of Medicine, Residency Program, University of Washington, Seattle, Washington.

Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.

出版信息

Head Neck. 2016 Sep;38(9):1318-23. doi: 10.1002/hed.24437. Epub 2016 Apr 7.

DOI:10.1002/hed.24437

PMID:27061333

Abstract

BACKGROUND

Postoperative cisplatin and radiation is the standard of care for high-risk squamous cell carcinoma of the head and neck (SCCHN). We have used cetuximab and radiation in the postoperative setting for patients deemed poor candidates for cisplatin.

METHODS

We retrospectively identified 40 patients who received cetuximab and radiation for resected locoregionally advanced SCCHN between 2006 and 2013 at our institution.

RESULTS

The 2-year Kaplan-Meier estimates were: overall survival (OS) 41%, recurrence-free survival (RFS) 34%, locoregional control 63%, and distant metastatic control 59%. Eastern Cooperative Oncology Group (ECOG) performance status ≥1 predicted for inferior OS (hazard ratio [HR] = 5.43; p = .003), RFS (HR = 4.07; p = .007), and locoregional control (HR = 4.92; p = .04) in multivariate analysis.

CONCLUSION

Patients with resected high-risk SCCHN treated with postoperative cetuximab and radiation have suboptimal therapeutic outcomes. Further study of the efficacy and cost-effectiveness compared to radiation alone is warranted. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1318-1323, 2016.

摘要

背景

术后顺铂和放疗是高危头颈部鳞状细胞癌（SCCHN）的标准治疗方案。对于被认为不适合使用顺铂的患者，我们在术后使用西妥昔单抗和放疗。

方法

我们回顾性确定了2006年至2013年间在本机构接受西妥昔单抗和放疗的40例局部区域晚期SCCHN切除患者。

结果

2年的Kaplan-Meier估计值为：总生存率（OS）41%，无复发生存率（RFS）34%，局部区域控制率63%，远处转移控制率59%。在多变量分析中，东部肿瘤协作组（ECOG）体能状态≥1预测较差的总生存率（风险比[HR]=5.43；p=0.003）、无复发生存率（HR=4.07；p=0.007）和局部区域控制率（HR=4.92；p=0.04）。