Definitive radiation with concurrent cetuximab vs. radiation with or without concurrent cytotoxic chemotherapy in older patients with squamous cell carcinoma of the head and neck: Analysis of the SEER-medicare linked database
•CTX-RT was associated with a significantly worse OS compared to CRT.•CTX-RT was associated with a similar OS compared to RT alone.•CTX-RT was independently associated with worse OS vs. CRT in multivariable analysis.•There was no difference in select toxicities between CTX-RT and CRT. To evaluate OS...
Gespeichert in:
| Veröffentlicht in: | Oral oncology 2018-11, Vol.86, p.132-140 |
|---|---|
| Hauptverfasser: | , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 140 |
|---|---|
| container_issue | |
| container_start_page | 132 |
| container_title | Oral oncology |
| container_volume | 86 |
| creator | Zandberg, Dan P. Cullen, Kevin Bentzen, Soren M. Goloubeva, Olga G. |
| description | •CTX-RT was associated with a significantly worse OS compared to CRT.•CTX-RT was associated with a similar OS compared to RT alone.•CTX-RT was independently associated with worse OS vs. CRT in multivariable analysis.•There was no difference in select toxicities between CTX-RT and CRT.
To evaluate OS and toxicity after definitive radiation with concurrent cetuximab (CTX-RT) compared to radiation with concurrent cytotoxic chemotherapy (CRT) in older HNSCC patients via the SEER-Medicare linked database.
We used the SEER-Medicare linked database to evaluate OS in HNSCC patients (Oropharynx, Larynx, Hypopharynx, Nasopharynx) diagnosed over 2005–2011, following FDA approval of cetuximab in combination with radiation therapy (RT) in March 2006.
2135 beneficiaries were identified. Median age was 73 (66–104) years. Primary was oropharynx (61%), hypopharynx (15%), nasopharynx (5%), and larynx (19%). CRT was platinum based in 82% of patients. CTX-RT was associated with worse OS compared to CRT (P |
| doi_str_mv | 10.1016/j.oraloncology.2018.09.023 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2132224590</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1368837518303464</els_id><sourcerecordid>2132224590</sourcerecordid><originalsourceid>FETCH-LOGICAL-c380t-e1cb97638d750d9fe19f99ac3048155880e1f85806731d4526a8749e41e5ca3b3</originalsourceid><addsrcrecordid>eNqNUctu1DAUjRCIlsIvIIsVmwQ7jhO7u6odHlKlSgXWlmPfMJ4m9tR2huZz-RM8TIsKq66uJZ-HzjlF8Y7gimDSfthUPqjRO-1H_2Opakx4hUWFa_qsOCa8EyVmgj7Pb9ryktOOHRWvYtxgjBlh-GVxRHGDRS3ocfHrAgbrbLI7QEEZq5L1Dv20aY10dphDAJeQhjTf2Un1aBer_3E-_Ll-Tv9QluSTv7Ma6TVMPq0hqO2CrEN-NBDQNitkXDxoxNtZTX6O2WkckVZBW-cnhfyAMhOtQRmknEEO9M0pOnNqXKKND99fV6vrcgJjMxHQaN0NGGRUUr2K8Lp4Magxwpv7e1J8_7j6dv65vLz69OX87LLUlONUAtG96FrKTcewEQMQMQihdK6KE8Y4x0AGzjhuO0pMw-pW8a4R0BBgWtGenhTvD7rb4G9niElONu7jKAc5mawJreu6YQJn6OkBqoOPMcAgtyG3GxZJsNxPLDfy8cRyP7HEQuaJM_ntvc_c58x_qQ-bZsDFAQA57c5CkFHnqnXuJ4BO0nj7FJ_f1nXFBA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2132224590</pqid></control><display><type>article</type><title>Definitive radiation with concurrent cetuximab vs. radiation with or without concurrent cytotoxic chemotherapy in older patients with squamous cell carcinoma of the head and neck: Analysis of the SEER-medicare linked database</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Zandberg, Dan P. ; Cullen, Kevin ; Bentzen, Soren M. ; Goloubeva, Olga G.</creator><creatorcontrib>Zandberg, Dan P. ; Cullen, Kevin ; Bentzen, Soren M. ; Goloubeva, Olga G.</creatorcontrib><description>•CTX-RT was associated with a significantly worse OS compared to CRT.•CTX-RT was associated with a similar OS compared to RT alone.•CTX-RT was independently associated with worse OS vs. CRT in multivariable analysis.•There was no difference in select toxicities between CTX-RT and CRT.
To evaluate OS and toxicity after definitive radiation with concurrent cetuximab (CTX-RT) compared to radiation with concurrent cytotoxic chemotherapy (CRT) in older HNSCC patients via the SEER-Medicare linked database.
We used the SEER-Medicare linked database to evaluate OS in HNSCC patients (Oropharynx, Larynx, Hypopharynx, Nasopharynx) diagnosed over 2005–2011, following FDA approval of cetuximab in combination with radiation therapy (RT) in March 2006.
2135 beneficiaries were identified. Median age was 73 (66–104) years. Primary was oropharynx (61%), hypopharynx (15%), nasopharynx (5%), and larynx (19%). CRT was platinum based in 82% of patients. CTX-RT was associated with worse OS compared to CRT (P < 0.005), and similar OS to RT (P = 0.21); 5-year OS was 46% for CRT, 35% for CTX-RT, 32% for RT. Patients were more likely to receive CTX-RT vs. CRT if they had oropharyngeal vs nasopharyngeal primary, Charlson comorbidity index 2 vs 0, older age at diagnosis. Multivariable Cox regression showed that CTX-RT was associated with a higher risk of death compared to CRT (hazard ratio = 1.23, 1.07–1.42; p = 0.005), after stratifying by stage and primary site, and adjusting for gender, race, age, income, Charlson comorbidity index, marital status, hospital type, and year of diagnosis. There were no differences in dysphagia, gastrostomy tube placement, pneumonia, and weight loss over the first 12 months after diagnosis.
Despite the limitations to comparative effectiveness evaluation in population-based registries, our data suggest that cytotoxic chemotherapy should be used with RT for eligible older HNSCC patients.</description><identifier>ISSN: 1368-8375</identifier><identifier>EISSN: 1879-0593</identifier><identifier>DOI: 10.1016/j.oraloncology.2018.09.023</identifier><identifier>PMID: 30409293</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Aged ; Aged, 80 and over ; Antineoplastic Agents - therapeutic use ; Carboplatin - therapeutic use ; Cetuximab ; Cetuximab - therapeutic use ; Chemoradiation ; Chemoradiotherapy - methods ; Cisplatin - therapeutic use ; Cohort Studies ; Elderly ; Female ; Head and Neck Neoplasms - mortality ; Head and Neck Neoplasms - therapy ; HNSCC ; Humans ; Male ; Medicare - statistics & numerical data ; Platinum overall survival ; Radiation ; SEER Program - statistics & numerical data ; Squamous Cell Carcinoma of Head and Neck - mortality ; Squamous Cell Carcinoma of Head and Neck - therapy ; Survival Analysis ; Treatment Outcome ; United States - epidemiology</subject><ispartof>Oral oncology, 2018-11, Vol.86, p.132-140</ispartof><rights>2018 Elsevier Ltd</rights><rights>Copyright © 2018 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c380t-e1cb97638d750d9fe19f99ac3048155880e1f85806731d4526a8749e41e5ca3b3</citedby><cites>FETCH-LOGICAL-c380t-e1cb97638d750d9fe19f99ac3048155880e1f85806731d4526a8749e41e5ca3b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1368837518303464$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30409293$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zandberg, Dan P.</creatorcontrib><creatorcontrib>Cullen, Kevin</creatorcontrib><creatorcontrib>Bentzen, Soren M.</creatorcontrib><creatorcontrib>Goloubeva, Olga G.</creatorcontrib><title>Definitive radiation with concurrent cetuximab vs. radiation with or without concurrent cytotoxic chemotherapy in older patients with squamous cell carcinoma of the head and neck: Analysis of the SEER-medicare linked database</title><title>Oral oncology</title><addtitle>Oral Oncol</addtitle><description>•CTX-RT was associated with a significantly worse OS compared to CRT.•CTX-RT was associated with a similar OS compared to RT alone.•CTX-RT was independently associated with worse OS vs. CRT in multivariable analysis.•There was no difference in select toxicities between CTX-RT and CRT.
To evaluate OS and toxicity after definitive radiation with concurrent cetuximab (CTX-RT) compared to radiation with concurrent cytotoxic chemotherapy (CRT) in older HNSCC patients via the SEER-Medicare linked database.
We used the SEER-Medicare linked database to evaluate OS in HNSCC patients (Oropharynx, Larynx, Hypopharynx, Nasopharynx) diagnosed over 2005–2011, following FDA approval of cetuximab in combination with radiation therapy (RT) in March 2006.
2135 beneficiaries were identified. Median age was 73 (66–104) years. Primary was oropharynx (61%), hypopharynx (15%), nasopharynx (5%), and larynx (19%). CRT was platinum based in 82% of patients. CTX-RT was associated with worse OS compared to CRT (P < 0.005), and similar OS to RT (P = 0.21); 5-year OS was 46% for CRT, 35% for CTX-RT, 32% for RT. Patients were more likely to receive CTX-RT vs. CRT if they had oropharyngeal vs nasopharyngeal primary, Charlson comorbidity index 2 vs 0, older age at diagnosis. Multivariable Cox regression showed that CTX-RT was associated with a higher risk of death compared to CRT (hazard ratio = 1.23, 1.07–1.42; p = 0.005), after stratifying by stage and primary site, and adjusting for gender, race, age, income, Charlson comorbidity index, marital status, hospital type, and year of diagnosis. There were no differences in dysphagia, gastrostomy tube placement, pneumonia, and weight loss over the first 12 months after diagnosis.
Despite the limitations to comparative effectiveness evaluation in population-based registries, our data suggest that cytotoxic chemotherapy should be used with RT for eligible older HNSCC patients.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antineoplastic Agents - therapeutic use</subject><subject>Carboplatin - therapeutic use</subject><subject>Cetuximab</subject><subject>Cetuximab - therapeutic use</subject><subject>Chemoradiation</subject><subject>Chemoradiotherapy - methods</subject><subject>Cisplatin - therapeutic use</subject><subject>Cohort Studies</subject><subject>Elderly</subject><subject>Female</subject><subject>Head and Neck Neoplasms - mortality</subject><subject>Head and Neck Neoplasms - therapy</subject><subject>HNSCC</subject><subject>Humans</subject><subject>Male</subject><subject>Medicare - statistics & numerical data</subject><subject>Platinum overall survival</subject><subject>Radiation</subject><subject>SEER Program - statistics & numerical data</subject><subject>Squamous Cell Carcinoma of Head and Neck - mortality</subject><subject>Squamous Cell Carcinoma of Head and Neck - therapy</subject><subject>Survival Analysis</subject><subject>Treatment Outcome</subject><subject>United States - epidemiology</subject><issn>1368-8375</issn><issn>1879-0593</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNUctu1DAUjRCIlsIvIIsVmwQ7jhO7u6odHlKlSgXWlmPfMJ4m9tR2huZz-RM8TIsKq66uJZ-HzjlF8Y7gimDSfthUPqjRO-1H_2Opakx4hUWFa_qsOCa8EyVmgj7Pb9ryktOOHRWvYtxgjBlh-GVxRHGDRS3ocfHrAgbrbLI7QEEZq5L1Dv20aY10dphDAJeQhjTf2Un1aBer_3E-_Ll-Tv9QluSTv7Ma6TVMPq0hqO2CrEN-NBDQNitkXDxoxNtZTX6O2WkckVZBW-cnhfyAMhOtQRmknEEO9M0pOnNqXKKND99fV6vrcgJjMxHQaN0NGGRUUr2K8Lp4Magxwpv7e1J8_7j6dv65vLz69OX87LLUlONUAtG96FrKTcewEQMQMQihdK6KE8Y4x0AGzjhuO0pMw-pW8a4R0BBgWtGenhTvD7rb4G9niElONu7jKAc5mawJreu6YQJn6OkBqoOPMcAgtyG3GxZJsNxPLDfy8cRyP7HEQuaJM_ntvc_c58x_qQ-bZsDFAQA57c5CkFHnqnXuJ4BO0nj7FJ_f1nXFBA</recordid><startdate>201811</startdate><enddate>201811</enddate><creator>Zandberg, Dan P.</creator><creator>Cullen, Kevin</creator><creator>Bentzen, Soren M.</creator><creator>Goloubeva, Olga G.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201811</creationdate><title>Definitive radiation with concurrent cetuximab vs. radiation with or without concurrent cytotoxic chemotherapy in older patients with squamous cell carcinoma of the head and neck: Analysis of the SEER-medicare linked database</title><author>Zandberg, Dan P. ; Cullen, Kevin ; Bentzen, Soren M. ; Goloubeva, Olga G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c380t-e1cb97638d750d9fe19f99ac3048155880e1f85806731d4526a8749e41e5ca3b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antineoplastic Agents - therapeutic use</topic><topic>Carboplatin - therapeutic use</topic><topic>Cetuximab</topic><topic>Cetuximab - therapeutic use</topic><topic>Chemoradiation</topic><topic>Chemoradiotherapy - methods</topic><topic>Cisplatin - therapeutic use</topic><topic>Cohort Studies</topic><topic>Elderly</topic><topic>Female</topic><topic>Head and Neck Neoplasms - mortality</topic><topic>Head and Neck Neoplasms - therapy</topic><topic>HNSCC</topic><topic>Humans</topic><topic>Male</topic><topic>Medicare - statistics & numerical data</topic><topic>Platinum overall survival</topic><topic>Radiation</topic><topic>SEER Program - statistics & numerical data</topic><topic>Squamous Cell Carcinoma of Head and Neck - mortality</topic><topic>Squamous Cell Carcinoma of Head and Neck - therapy</topic><topic>Survival Analysis</topic><topic>Treatment Outcome</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zandberg, Dan P.</creatorcontrib><creatorcontrib>Cullen, Kevin</creatorcontrib><creatorcontrib>Bentzen, Soren M.</creatorcontrib><creatorcontrib>Goloubeva, Olga G.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Oral oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zandberg, Dan P.</au><au>Cullen, Kevin</au><au>Bentzen, Soren M.</au><au>Goloubeva, Olga G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Definitive radiation with concurrent cetuximab vs. radiation with or without concurrent cytotoxic chemotherapy in older patients with squamous cell carcinoma of the head and neck: Analysis of the SEER-medicare linked database</atitle><jtitle>Oral oncology</jtitle><addtitle>Oral Oncol</addtitle><date>2018-11</date><risdate>2018</risdate><volume>86</volume><spage>132</spage><epage>140</epage><pages>132-140</pages><issn>1368-8375</issn><eissn>1879-0593</eissn><abstract>•CTX-RT was associated with a significantly worse OS compared to CRT.•CTX-RT was associated with a similar OS compared to RT alone.•CTX-RT was independently associated with worse OS vs. CRT in multivariable analysis.•There was no difference in select toxicities between CTX-RT and CRT.
To evaluate OS and toxicity after definitive radiation with concurrent cetuximab (CTX-RT) compared to radiation with concurrent cytotoxic chemotherapy (CRT) in older HNSCC patients via the SEER-Medicare linked database.
We used the SEER-Medicare linked database to evaluate OS in HNSCC patients (Oropharynx, Larynx, Hypopharynx, Nasopharynx) diagnosed over 2005–2011, following FDA approval of cetuximab in combination with radiation therapy (RT) in March 2006.
2135 beneficiaries were identified. Median age was 73 (66–104) years. Primary was oropharynx (61%), hypopharynx (15%), nasopharynx (5%), and larynx (19%). CRT was platinum based in 82% of patients. CTX-RT was associated with worse OS compared to CRT (P < 0.005), and similar OS to RT (P = 0.21); 5-year OS was 46% for CRT, 35% for CTX-RT, 32% for RT. Patients were more likely to receive CTX-RT vs. CRT if they had oropharyngeal vs nasopharyngeal primary, Charlson comorbidity index 2 vs 0, older age at diagnosis. Multivariable Cox regression showed that CTX-RT was associated with a higher risk of death compared to CRT (hazard ratio = 1.23, 1.07–1.42; p = 0.005), after stratifying by stage and primary site, and adjusting for gender, race, age, income, Charlson comorbidity index, marital status, hospital type, and year of diagnosis. There were no differences in dysphagia, gastrostomy tube placement, pneumonia, and weight loss over the first 12 months after diagnosis.
Despite the limitations to comparative effectiveness evaluation in population-based registries, our data suggest that cytotoxic chemotherapy should be used with RT for eligible older HNSCC patients.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>30409293</pmid><doi>10.1016/j.oraloncology.2018.09.023</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1368-8375 |
| ispartof | Oral oncology, 2018-11, Vol.86, p.132-140 |
| issn | 1368-8375 1879-0593 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2132224590 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Aged Aged, 80 and over Antineoplastic Agents - therapeutic use Carboplatin - therapeutic use Cetuximab Cetuximab - therapeutic use Chemoradiation Chemoradiotherapy - methods Cisplatin - therapeutic use Cohort Studies Elderly Female Head and Neck Neoplasms - mortality Head and Neck Neoplasms - therapy HNSCC Humans Male Medicare - statistics & numerical data Platinum overall survival Radiation SEER Program - statistics & numerical data Squamous Cell Carcinoma of Head and Neck - mortality Squamous Cell Carcinoma of Head and Neck - therapy Survival Analysis Treatment Outcome United States - epidemiology |
| title | Definitive radiation with concurrent cetuximab vs. radiation with or without concurrent cytotoxic chemotherapy in older patients with squamous cell carcinoma of the head and neck: Analysis of the SEER-medicare linked database |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-10T08%3A33%3A10IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Definitive%20radiation%20with%20concurrent%20cetuximab%20vs.%20radiation%20with%20or%20without%20concurrent%20cytotoxic%20chemotherapy%20in%20older%20patients%20with%20squamous%20cell%20carcinoma%20of%20the%20head%20and%20neck:%20Analysis%20of%20the%20SEER-medicare%20linked%20database&rft.jtitle=Oral%20oncology&rft.au=Zandberg,%20Dan%20P.&rft.date=2018-11&rft.volume=86&rft.spage=132&rft.epage=140&rft.pages=132-140&rft.issn=1368-8375&rft.eissn=1879-0593&rft_id=info:doi/10.1016/j.oraloncology.2018.09.023&rft_dat=%3Cproquest_cross%3E2132224590%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2132224590&rft_id=info:pmid/30409293&rft_els_id=S1368837518303464&rfr_iscdi=true |