Therapeutic efficacy of radiotherapy combined with anti-epidermal growth factor receptor monoclonal antibody in treatment of locally advanced squamous cell carcinoma of the head and neck

Abstract

Objective To analyze the therapeutic efficacy of radiotherapy combined with antiepidermal growth factor receptor (EGFR) monoclonal antibody in the treatment of locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN).Methods From January 2009 to December 2011,77SCCHN patients,who received intensity-modulated radiotherapy (IMRT) combined with cetuximab or nimotuzumab,were included in the study group.Another 72 LA-SCCHN patients,who received radiotherapy alone in the same period,were chosen as a control group.The control group was similar to the study group in sex,age,primary site of tumor,staging,and radiation technique.The two groups were compared in terms of local control (LC),overall survival (OS),disease-free survival (DFS),and acute side effects.The Kaplan-Meier method was used for calculating LC,OS,and DFS rates,and the differences between the two groups were analyzed by Logrank test.Multivariate prognostic analysis was performed using a Cox model.Results The median follow-ups were 18.0 months in the study group and 19.5 months in the control group;the follow-up rate was 100％ in both groups.The 2-year LC rate of study group was significantly higher than that of control group (78％ vs 60％,x2 =4.88,P =0.027).There were no significant differences in 2-year OS rate (64％ vs 59％,x2 =0.870,P=0.351) and DFS rate (60％ vs 46％,x2 =2.12,P=0.146)between the two groups.Compared with the control group,the study group had a significantly higher incidence rate of grade 3 +4 radiation mucositis (51％ vs 17％,x2 =19.09,P =0.000) and a significantly higher incidence rate of leukocyte reduction (8％ vs 0％,x2 =4.00,P =0.045).Multivariate prognostic analysis showed that primary site of tumor,T stage,N stage,whether to perform concomitant chemotherapy,and whether to be combined with anti-EGFR monoclonal antibody were the influential factors for LC.Conclusions Compared with IMRT alone,IMRT combined with anti-EGFR monoclonal antibody can increase LC rate in the treatment of LA-SCCHN,but cannot significantly improve OS and DFS rates.Furthermore,it has tolerable side effects. Key words: Neoplasms of the head and neck/intensity-modulated radiotherapy ; Neoplasms of the head and neck/targeted therapy; Epidermal growth factor receptor inhibitors; Prognosis