局部晚期头颈部癌患者接受根治性放疗和同期西妥昔单抗治疗后总生存期降低：国家癌症数据库分析。
Decreased overall survival in patients with locally advanced head and neck cancer receiving definitive radiotherapy and concurrent cetuximab: National Cancer Database analysis.
机构信息
Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, Illinois, USA.
Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
出版信息
Head Neck. 2022 Jul;44(7):1528-1544. doi: 10.1002/hed.27050. Epub 2022 Apr 7.
BACKGROUND
Recently, randomized trials have questioned the efficacy of cetuximab-based bioradiotherapy compared to chemoradiation for patients with squamous cell carcinoma of the oropharynx, larynx, and hypopharynx (HNSCC). We compared the OS of patients treated with radiotherapy alone (RTonly), chemoradiotherapy (chemoRT), and bioradiotherapy (cetuxRT).
METHODS
Patients with stage III-IVB HNSCC treated with RTonly, chemoRT, or cetuxRT were identified in the National Cancer Database. OS was estimated using Cox proportional hazards. Analyses were conducted on the overall cohort and propensity matched cohorts.
RESULTS
31 014 patients were treated with RTonly (22%), chemoRT (72%), or cetuxRT (6%) from 2013 to 2016. The 2-year OS was 69% for RTonly, 79% for chemoRT, and 66% for cetuxRT (p < 0.001). In the overall and propensity-matched cohorts, chemoRT and RTonly were associated with improved OS as compared to cetuxRT (p ≤ 0.001).
CONCLUSION
Compared to chemoRT or RTonly, cetuxRT is associated with decreased OS for patients with HNSCC, suggesting minimal benefit of bioradiotherapy in this population.
背景
最近，随机试验对西妥昔单抗联合生物放疗与单纯放化疗治疗口咽、喉和下咽（HNSCC）鳞状细胞癌患者的疗效提出了质疑。我们比较了单纯放疗（RTonly）、放化疗（chemoRT）和生物放疗（cetuxRT）治疗患者的总生存期（OS）。
方法
在国家癌症数据库中确定了 2013 年至 2016 年间接受 RTonly、chemoRT 或 cetuxRT 治疗的 III-IVB 期 HNSCC 患者。采用 Cox 比例风险估计 OS。对总体队列和倾向评分匹配队列进行了分析。
结果
2013 年至 2016 年间，31014 例患者接受了 RTonly（22%）、chemoRT（72%）或 cetuxRT（6%）治疗。RTonly、chemoRT 和 cetuxRT 的 2 年 OS 分别为 69%、79%和 66%（p<0.001）。在总体和倾向评分匹配队列中，与 cetuxRT 相比，chemoRT 和 RTonly 与改善 OS 相关（p≤0.001）。
结论
与 chemoRT 或 RTonly 相比，cetuxRT 与 HNSCC 患者的 OS 降低相关，表明该人群中生物放疗的获益极小。
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