Fung Andrea S, Afzal Arfan Raheen, Banerjee Robyn, Debenham Brock, Hao Desiree
Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
Surveillance and Reporting, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada.
Head Neck. 2021 Jan;43(1):153-163. doi: 10.1002/hed.26469. Epub 2020 Sep 19.
This population-based retrospective study compares the efficacy of cisplatin (cis-RT) vs cetuximab (cetux-RT) with concurrent radiation as definitive treatment in patients with oropharyngeal carcinoma (OPC).
Patients with OPC treated in Alberta with cis-RT or cetux-RT between 2006 and 2016 were evaluated. Median disease-free survival (DFS) and overall survival (OS) were assessed using the Kaplan-Meier method. Multivariable analysis (MVA) was completed with a Cox proportional hazards model.
Among 546 patients with OPC, 431 (78.9%) received cis-RT and 115 (21.1%) cetux-RT. Patients treated with cetux-RT were more likely to develop a recurrence after treatment compared to cis-RT (25% vs 15%, P = .01). On MVA, current smoking, human papillomavirus (HPV)-negative status, higher Charlson comorbidity index (CCI), T-stage, and cetux-RT predicted for worse DFS and OS. Outcomes in older patients with a higher CCI still favored cis-RT.
Our data reaffirm results from randomized studies showing better survival outcomes with cis-RT compared to cetux-RT even among those who are >65 with CCI ≥3.
这项基于人群的回顾性研究比较了顺铂（顺铂同步放疗）与西妥昔单抗（西妥昔单抗同步放疗）联合同步放疗作为口咽癌（OPC）患者确定性治疗的疗效。
对2006年至2016年间在艾伯塔省接受顺铂同步放疗或西妥昔单抗同步放疗的OPC患者进行评估。采用Kaplan-Meier方法评估无病生存期（DFS）和总生存期（OS）的中位数。使用Cox比例风险模型完成多变量分析（MVA）。
在546例OPC患者中，431例（78.9%）接受顺铂同步放疗，115例（21.1%）接受西妥昔单抗同步放疗。与顺铂同步放疗相比，接受西妥昔单抗同步放疗的患者治疗后更易复发（25%对15%，P = 0.01）。在多变量分析中，当前吸烟、人乳头瘤病毒（HPV）阴性状态、较高的Charlson合并症指数（CCI）、T分期和西妥昔单抗同步放疗预示着DFS和OS较差。CCI较高的老年患者的结局仍有利于顺铂同步放疗。
我们的数据再次证实了随机研究的结果，表明即使在CCI≥3的65岁以上患者中，顺铂同步放疗的生存结局也优于西妥昔单抗同步放疗。
Zotero 插件