Recurrence Patterns for Head and Neck Squamous Cell Carcinoma Treated with Cetuximab versus Non-cetuximab Therapy

Abstract

Objectives:

The respective roles of platinum-based chemotherapy and cetuximab therapy in the treatment of head and neck squamous cell carcinoma (HNSCC) have yet to be strictly defined. This study investigates the patterns of recurrence for patients with HNSCC treated with cetuximab versus non-cetuximab therapies.

Methods:

Retrospective case-control study at a tertiary academic practice. Patients with recurrent HNSCC that received primary non-surgical therapy between 2006 and 2009 were retrospectively reviewed. Patients were stratified by treatment into 2 primary groups: 14 patients who received cetuximab plus radiotherapy and 30 patients who received non-cetuximab radiotherapies. The 2 groups were compared, and the primary endpoint was the time to locoregional recurrence. Subgroup analysis was performed for the non-cetuximab radiotherapy group.

Results:

Overall stage (P = 0.423), T stage (P = 0.190), smoking history (P =1.000), alcohol use (P = 0.498), and comorbidity based on ASA score (P = 1.000) were not significantly different between the 2 groups. Patients in the cetuximab group were on average older; 68.9 versus 61.3 years old (P = 0.049). Median time to recurrence for the cetuximab group was 5.3 ± 3 months versus 8.7 ±6 months for non-cetuximab patients (P = 0.020); subgroup analysis showed 10.7 ± 7.3 months till recurrence for the concurrent chemoradiotherapy subgroup (P = 0.023). None of the patients in the cetuximab group were disease-free for one year or longer.

Conclusions:

Patients with recurrent HNSCC treated primarily with cetuximab and radiotherapy alone have a significantly shorter time to recurrence than patients treated with conventional therapies.