Hecht Markus, Hahn Dennis, Wolber Philipp, Hautmann Matthias G, Reichert Dietmar, Weniger Steffi, Belka Claus, Bergmann Tobias, Göhler Thomas, Welslau Manfred, Große-Thie Christina, Guntinas-Lichius Orlando, von der Grün Jens, Balermpas Panagiotis, Orlowski Katrin, Messinger Diethelm, Stenzel Karsten G, Fietkau Rainer
Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany.
Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), 91054 Erlangen, Germany.
Cancers (Basel). 2021 Jul 8;13(14):3413. doi: 10.3390/cancers13143413.
Treatment options of locoregional recurrent head and neck squamous cell cancer (HNSCC) include both local strategies as surgery or re-radiotherapy and systemic therapy. In this prospective, multi-center, non-interventional study, patients were treated either with platinum-based chemotherapy and cetuximab (CT + Cet) or re-radiotherapy and cetuximab (RT + Cet). In the current analysis, progression-free survival (PFS) and overall survival (OS) were compared in patients with locoregional recurrence. Four hundred seventy patients were registered in 97 German centers. After exclusion of patients with distant metastases, a cohort of 192 patients was analyzed (129 CT + Cet, 63 RT + Cet). Radiotherapy was delivered as re-irradiation to 70% of the patients. The mean radiation dose was 51.8 Gy, whereas a radiation dose of ≥60 Gy was delivered in 33% of the patients. Chemotherapy mainly consisted of cisplatin/5-flurouracil (40%) or carboplatin/5-flurouracil (29%). The median PFS was 9.2 months in the RT + Cet group versus 5.1 months in the CT + Cet group (hazard ratio for disease progression or death, 0.40, 95% CI, 0.27-0.57, < 0.0001). Median OS was 12.8 months in the RT + Cet group versus 7.9 months in the CT + Cet group (hazard ratio for death, 0.50, 95% CI, 0.33-0.75, = 0.0008). In conclusion, radiotherapy combined with cetuximab improved survival compared to chemotherapy combined with cetuximab in locally recurrent HNSCC.
局部区域复发性头颈部鳞状细胞癌（HNSCC）的治疗选择包括手术或再放疗等局部策略以及全身治疗。在这项前瞻性、多中心、非干预性研究中，患者接受铂类化疗联合西妥昔单抗（CT + Cet）或再放疗联合西妥昔单抗（RT + Cet）治疗。在当前分析中，对局部区域复发患者的无进展生存期（PFS）和总生存期（OS）进行了比较。97个德国中心登记了470例患者。排除远处转移患者后，对192例患者组成的队列进行了分析（129例CT + Cet，63例RT + Cet）。70%的患者接受了再放疗。平均放疗剂量为51.8 Gy，33%的患者放疗剂量≥60 Gy。化疗主要包括顺铂/5-氟尿嘧啶（40%）或卡铂/5-氟尿嘧啶（29%）。RT + Cet组的中位PFS为9.2个月，而CT + Cet组为5.1个月（疾病进展或死亡的风险比为0.40，95%CI为0.27 - 0.57，<0.0001）。RT + Cet组的中位OS为12.8个月，而CT + Cet组为7.9个月（死亡风险比为0.50，95%CI为0.33 - 0.75，=0.0008）。总之，与化疗联合西妥昔单抗相比，放疗联合西妥昔单抗可提高局部复发性HNSCC患者的生存率。
