Concurrent cetuximab and postoperative radiation in resected high-risk squamous cell carcinomas of the head and neck: A single-institution experience

• Published in: Head & neck 2016-09, Vol.38 (9), p.1318-1323
• Main Authors: Araki, Daisuke, Redman, Mary W., Martins, Renato, Eaton, Keith, Baik, Christina, Chow, Laura, Goulart, Bernardo, Lee, Sylvia, Santana-Davila, Rafael, Liao, Jay, Parvathaneni, Upendra, Laramore, George, Futran, Neal, Mendez, Eduardo, Bhrany, Amit, Rodriguez, Cristina P.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antineoplastic Agents, Immunological; Cancer Care Facilities; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - therapy; Cause of Death; cetuximab; Cetuximab - adverse effects; Cetuximab - therapeutic use; Chemoradiotherapy, Adjuvant; Cohort Studies; Disease-Free Survival; Female; Head and Neck Neoplasms - mortality; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - therapy; high-risk features; Humans; Kaplan-Meier Estimate; locoregionally advanced; Male; Middle Aged; Neck; Neoplasm Invasiveness - pathology; Neoplasm Staging; Postoperative Care - methods; postoperative radiation; Prognosis; Proportional Hazards Models; Retrospective Studies; Risk Assessment; Squamous Cell Carcinoma of Head and Neck; squamous cell carcinoma of the head and neck; Survival Analysis; Treatment Outcome; United States
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.24437

Background Postoperative cisplatin and radiation is the standard of care for high‐risk squamous cell carcinoma of the head and neck (SCCHN). We have used cetuximab and radiation in the postoperative setting for patients deemed poor candidates for cisplatin. Methods We retrospectively identified 40 patients who received cetuximab and radiation for resected locoregionally advanced SCCHN between 2006 and 2013 at our institution. Results The 2‐year Kaplan–Meier estimates were: overall survival (OS) 41%, recurrence‐free survival (RFS) 34%, locoregional control 63%, and distant metastatic control 59%. Eastern Cooperative Oncology Group (ECOG) performance status ≥1 predicted for inferior OS (hazard ratio [HR] = 5.43; p = .003), RFS (HR = 4.07; p = .007), and locoregional control (HR = 4.92; p = .04) in multivariate analysis. Conclusion Patients with resected high‐risk SCCHN treated with postoperative cetuximab and radiation have suboptimal therapeutic outcomes. Further study of the efficacy and cost‐effectiveness compared to radiation alone is warranted. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1318–1323, 2016