Combination of post-operative radiotherapy and cetuximab for high-risk cutaneous squamous cell cancer of the head and neck: A propensity score analysis.
OBJECTIVES
The objective of this study was to investigate the safety, tolerability and preliminary efficacy of radiotherapy plus cetuximab in high risk CSCC patients.


MATERIALS AND METHODS
Patients with high-risk CSCC diagnosed between 2006 and 2013 were analyzed. Patients were divided into two groups: radiotherapy alone versus radiotherapy plus cetuximab. Among 68 patients meeting study criteria, we identified 29 treated with cetuximab plus RT and 39 with RT alone. Primary analysis examined disease-free and overall survival, freedom from local and distant recurrence in the propensity score matched cohort. Propensity score analysis was performed with weighted factors including: Charlson Comorbidity Index score, age. KPS, primary location, T and N stage, recurrent status, margin status, LVSI, PNI and grade. Toxicity was assessed using the CTCAE v4.0.


RESULTS
Median follow-up for living patients was 30 months. Patients in the cetuximab group were more likely to have advanced N stage, positive margins and recurrent disease. After propensity score matching the groups were well balanced. Six patients experienced ≥ grade 3 acute toxicity in the cetuximab group. The 1-year, 2-year and 5-year progression free survival (PFS) for patients in the cetuximab group were 86%, 72% and 66%, respectively. The 1-year, 2-year and 5-year overall survival (OS) for patients in the cetuximab group was 98%, 80% and 80%, respectively.


CONCLUSIONS
Although limited by small numbers, the combination of cetuximab and radiotherapy in CSCC appears well tolerated there were more long-term survivors and less distant metastasis in the cetuximab group. These promising finding warrant further studies.
['Palmer|Joshua D|JD|', 'Schneider|Charles J|CJ|', 'Hockstein|Neil|N|', 'Hanlon|Alexandra L|AL|', 'Silberg|Jordan|J|', 'Strasser|Jon|J|', 'Mauer|Elizabeth A|EA|', 'Dzeda|Michael|M|', 'Witt|Robert|R|', 'Raben|Adam|A|']
D000368:Aged D000369:Aged, 80 and over D000074322:Antineoplastic Agents, Immunological D000068818:Cetuximab D059248:Chemoradiotherapy D015331:Cohort Studies D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D009364:Neoplasm Recurrence, Local D011182:Postoperative Care D012878:Skin Neoplasms D000077195:Squamous Cell Carcinoma of Head and Neck D016019:Survival Analysis
Post-operative radiotherapy Cetuximab Head and neck Survival Cutaneous squamous cell carcinoma