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头颈部鳞状细胞癌放疗联合西妥昔单抗或顺铂:随机对照试验的最新系统评价和荟萃分析

Radiotherapy plus cetuximab or cisplatin in head and neck squamous cell carcinoma: an updated systematic review and meta-analysis of randomized controlled trials.

作者信息

Li Yuting, Yang Chensu, Gan Yong, Lu Furong, Qin You

机构信息

Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 156 Wujiadun, Jianghan District, Wuhan, 430022, Hubei, China.

School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.

出版信息

Eur Arch Otorhinolaryngol. 2023 Jan;280(1):11-22. doi: 10.1007/s00405-022-07572-8. Epub 2022 Aug 20.

Abstract

BACKGROUND

The present meta-analysis was updated with randomized controlled trials (RCTs) to revaluate the efficacy and safety of cetuximab vs. cisplatin combined with radiotherapy in patients of head and neck squamous cell carcinoma (HNSCC).

METHODS

A meta-analysis containing RCTs that compared the efficacy or toxicity of cetuximab and cisplatin in HNSCC patients was conducted.

RESULTS

Seven RCTs were included in the final analysis. The patients treated by cetuximab plus radiotherapy showed an inferior overall survival (OS) and locoregional control (LRC) compared to cisplatin plus radiotherapy. The tendency of progression-free survival (PFS) was in agreement with OS and LRC. Subgroup analysis showed that cetuximab had poorer OS relative to cisplatin in the absence of induction chemotherapy. The profile of severe adverse events (SAEs) varied between the two groups, no significant difference in total SAEs was shown for the two arms.

DISCUSSION

Cetuximab combined with radiotherapy shows significantly reduced therapeutic efficacy compared to cisplatin plus radiotherapy in HNSCC patients.

摘要

背景

本荟萃分析纳入随机对照试验(RCT)以重新评估西妥昔单抗与顺铂联合放疗治疗头颈部鳞状细胞癌(HNSCC)患者的疗效和安全性。

方法

开展一项荟萃分析,纳入比较西妥昔单抗与顺铂对HNSCC患者疗效或毒性的RCT。

结果

最终分析纳入7项RCT。与顺铂联合放疗相比,接受西妥昔单抗联合放疗的患者总生存期(OS)和局部区域控制(LRC)较差。无进展生存期(PFS)趋势与OS和LRC一致。亚组分析显示,在未进行诱导化疗的情况下,与顺铂相比,西妥昔单抗的OS较差。两组严重不良事件(SAE)情况不同,两组总SAE无显著差异。

讨论

在HNSCC患者中,与顺铂联合放疗相比,西妥昔单抗联合放疗的治疗效果显著降低。

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