Department of Dermatology, Saitama Medical University, 38, Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0495, Japan; Department of Dermatologic Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 1040045, Japan.
Department of Dermatologic Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 1040045, Japan.
Eur J Cancer. 2020 Mar;127:108-117. doi: 10.1016/j.ejca.2019.12.018. Epub 2020 Jan 28.
Cutaneous squamous cell carcinoma (cSCC) is the second most common type of skin cancer. Few patients with cSCC experience metastases, but the prognosis of advanced cSCC (acSCC) is dismal. Evidence regarding systemic therapy for acSCC is limited. Therefore, we aimed to determine the most effective systemic treatment for acSCC.
This retrospective study involved 16 Japanese institutions. We documented patient and tumour characteristics and disease course of patients with acSCC who received systemic therapy between 1st January 2006 and 31st December 2015. We compared the overall survival (OS) and progression-free survival (PFS) for (1) platinum versus non-platinum groups, (2) radiation plus chemotherapy first-line therapy (RCT) versus non-RCT groups and (3) platinum-based RCT versus non-platinum-based RCT groups.
Although the use of platinum-based systemic therapy was not associated with statistically significant improvements in PFS and OS, there were significant differences between the RCT and non-RCT groups (PFS: p < 0.001, OS: p = 0.003). In the subgroup analysis, RCT significantly prolonged PFS and OS in the nodal SCC (nSCC) group. For the RCT and non-RCT groups, the median OS was 110 and 14 months, respectively, and the 5-year OS rate was 54% and 21%, respectively.
RCT could improve OS in patients with nSCC. However, further multicenter prospective studies are needed to establish evidence for superiority of RCT.
皮肤鳞状细胞癌（cSCC）是第二常见的皮肤癌类型。少数 cSCC 患者发生转移，但晚期 cSCC（acSCC）的预后较差。关于 acSCC 的系统治疗证据有限。因此，我们旨在确定 acSCC 最有效的系统治疗方法。
本回顾性研究涉及 16 家日本机构。我们记录了接受 2006 年 1 月 1 日至 2015 年 12 月 31 日期间系统治疗的 acSCC 患者的患者和肿瘤特征以及疾病过程。我们比较了（1）铂类与非铂类组、（2）放疗联合化疗一线治疗（RCT）与非 RCT 组和（3）铂类 RCT 与非铂类 RCT 组的总生存期（OS）和无进展生存期（PFS）。
尽管铂类系统治疗的使用与 PFS 和 OS 的统计学显著改善无关，但 RCT 组与非 RCT 组之间存在显著差异（PFS：p<0.001，OS：p=0.003）。在亚组分析中，RCT 显著延长了淋巴结 SCC（nSCC）组的 PFS 和 OS。对于 RCT 和非 RCT 组，中位 OS 分别为 110 和 14 个月，5 年 OS 率分别为 54%和 21%。
RCT 可改善 nSCC 患者的 OS。然而，需要进一步的多中心前瞻性研究来确立 RCT 优越性的证据。
