Head and neck cancer recurrence and mortality in nonselective cyclooxygenase inhibitor users.
OBJECTIVE
To determine whether ongoing use of a cyclooxygenase (COX) inhibitor is associated with a reduction in mortality and disease recurrence after head and neck cancer treatment.


METHODS
Retrospective case-control study. Patients A total of 325 potential subjects with head and neck squamous cell carcinoma were identified using an electronic patient database. Main Outcome Measure The rate of COX inhibitor use among patients who had died or whose disease had recurred (cases) was compared with the rate of use among survivors or those without recurrence (controls). The comparison was controlled for tumor site, tumor stage, treatment received, age, sex, race, smoking, and alcohol use.


RESULTS
The 325 patients were compared by logistic regressions, with recurrence rate and survival status as the dependent variables. There was no difference in COX inhibitor exposure between patients with recurrence and those with no recurrence (P = .42) or between survivors and those who died of disease (P = .66). The median survival of COX inhibitor users, however, was 96 months, compared with 47 months in nonusers. The only independent variable with a significant impact on recurrence and survival was tumor stage at the time of diagnosis.


CONCLUSIONS
Although preliminary in vitro studies suggest an antitumor effect of COX inhibitors in head and neck cancer, this study found no difference in head and neck cancer recurrence or survival in nonselective COX inhibitor users vs nonusers. A randomized, double-blinded controlled trial is needed to determine if COX inhibitors are an effective chemopreventive therapy in patients with head and neck cancer.
Gillespie
M Boyd
MB
Department of Otolaryngology-Head and Neck Surgery and Medicine, Medical University of South Carolina, Charleston, USA. gillesmb@musc.edu
Moody
Marcus W
MW
Lee
Fu-Shing
FS
Poole
Lynn J
LJ
Hornig
Joshua D
JD
Lathers
Deanne
D
Young
M Rita
MR
Day
Terry A
TA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology; D016022:Case-Control Studies; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use*; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000473:pathology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D015996:Survival Rate
D016861:Cyclooxygenase Inhibitors