title: Concomitant platinum-based chemotherapy or cetuximab with radiotherapy for locally advanced head and neck cancer: a systematic review and meta-analysis of published studies.
abstract: The combinations of radiotherapy (RT) plus chemotherapy (CTRT) with cisplatin or, alternatively, RT plus cetuximab (RT+CET), are the treatments of choice for locally advanced squamous cell carcinoma of the head and neck (HNSCC). We performed a systematic review and meta-analysis of published studies reporting the efficacy of these 2 combined modality therapies for the treatment of locoregionally advanced HNSCC. We performed a systematic search of PUBMED, EMBASE, Web of Science, SCOPUS, and the Cochrane Register of Controlled Trials. Meta-analysis was performed using the fixed- or random-effects models. The primary endpoints were 2-year overall survival (OS), 2-year progression-free survival (PFS), and 2-year locoregional relapse (LRR), reported as risk ratios (RRs) and 95% confidence intervals (CIs). Fifteen trials, including a total of 1808 patients, were analysed. Three of these trials were prospective, and 12 were retrospective. Overall, for locally advanced HNSCC, concomitant CTRT significantly improved 2-year OS (RR=0.66; 95% CI, 0.46-0.94; P=0.02), 2-year PFS (RR=0.68; 95% CI, 0.53-0.87; P=0.002), and 2-year LRR (RR=0.63; 95% CI, 0.45-0.87; P=0.005) compared to RT+CET. For the treatment of locally advanced HNSCC, platinum-based CTRT is associated with a better OS and PFS compared to RT+CET, and this is probably attributed to improved locoregional disease control. Thus, platinum-based CTRT should remain the standard of care until equivalence with RT+CET can be prospectively demonstrated.
authors.affiliation: Medical Oncology Unit, Oncology Department, Azienda Ospedaliera Treviglio, Treviglio, BG, Italy. Electronic address: faupe@libero.it.
authors.forename: Fausto
authors.initials: F
authors.lastname: Petrelli
authors.affiliation: Medical Oncology Unit, Oncology Department, Azienda Ospedaliera Treviglio, Treviglio, BG, Italy. Electronic address: artefice2003@hotmail.com.
authors.forename: Andrea
authors.initials: A
authors.lastname: Coinu
authors.affiliation: Radiotherapy Unit, Oncology Department, Azienda Ospedaliera Treviglio, Treviglio, BG, Italy. Electronic address: riboldi.valentina79@gmail.com.
authors.forename: Valentina
authors.initials: V
authors.lastname: Riboldi
authors.affiliation: Medical Oncology Unit, Oncology Department, Azienda Ospedaliera Treviglio, Treviglio, BG, Italy. Electronic address: karenbf_it@yahoo.it.
authors.forename: Karen
authors.initials: K
authors.lastname: Borgonovo
authors.affiliation: Medical Oncology Unit, Oncology Department, Azienda Ospedaliera Treviglio, Treviglio, BG, Italy. Electronic address: mara.ghily@alice.it.
authors.forename: Mara
authors.initials: M
authors.lastname: Ghilardi
authors.affiliation: Medical Oncology Unit, Oncology Department, Azienda Ospedaliera Treviglio, Treviglio, BG, Italy. Electronic address: mary_cabiddu@yahoo.it.
authors.forename: Mary
authors.initials: M
authors.lastname: Cabiddu
authors.affiliation: Medical Oncology Unit, Oncology Department, Azienda Ospedaliera Treviglio, Treviglio, BG, Italy. Electronic address: lo.ve@tiscali.it.
authors.forename: Veronica
authors.initials: V
authors.lastname: Lonati
authors.affiliation: Radiotherapy Unit, Oncology Department, Azienda Ospedaliera Treviglio, Treviglio, BG, Italy. Electronic address: enrico.sarti@ospedale.treviglio.bg.it.
authors.forename: Enrico
authors.initials: E
authors.lastname: Sarti
authors.affiliation: Medical Oncology Unit, Oncology Department, Azienda Ospedaliera Treviglio, Treviglio, BG, Italy. Electronic address: sandro.barni@ospedale.treviglio.bg.it.
authors.forename: Sandro
authors.initials: S
authors.lastname: Barni
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D000068818:Cetuximab; D003131:Combined Modality Therapy; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D006801:Humans; D009944:Organoplatinum Compounds / Q000627:therapeutic use*
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000068818:Cetuximab
keywords: Cetuximab; Chemoradiotherapy; Cisplatin; Head and neck cancer; Locally advanced; Overall survival