Postoperative Radiotherapy ± Cetuximab for Intermediate-Risk Head and Neck Cancer.
Publication/Presentation Date
4-20-2025
Abstract
PURPOSE: Radiotherapy (RT)/cetuximab (C) demonstrated superiority over RT alone for locally advanced squamous head and neck cancer. We tested this in completely resected, intermediate-risk cancer.
METHODS: Patients had squamous cell carcinoma of the head and neck (SCCHN) of the oral cavity, oropharynx, or larynx, with one or more risk factors warranting postoperative RT. Patients were randomly assigned 1:1 to intensity-modulated RT (60-66 Gy) with once-per-week C or RT alone. The primary hypothesis was that RT + C would improve overall survival (OS) in randomly assigned/eligible patients, with a prespecified secondary plan to test this in the human papillomavirus (HPV)-negative subpopulation. Disease-free survival (DFS) and toxicity were secondary end points. OS and DFS were tested via stratified log-rank test; toxicity was compared via Fisher's exact test.
RESULTS: We enrolled 702 patients from November 2009 to March 2018; 577 were randomly assigned/eligible. Most (63.6%) had oral cavity cancer and most (84.6%) had high epidermal growth factor receptor expression. There were fewer deaths (184) than expected. OS (median follow up, 7.2 years) was not significantly improved (hazard ratio [HR], 0.81; one-sided
CONCLUSION: RT + C significantly improved DFS, but not OS, with no increase in long-term toxicity, compared with RT alone for resected, intermediate-risk SCCHN. RT + C is an appropriate option for carefully selected patients with HPV-negative disease.
Volume
43
Issue
12
First Page
1474
Last Page
1487
ISSN
1527-7755
Published In/Presented At
Machtay, M., Torres-Saavedra, P. A., Thorstad, W., Nguyen-Tân, P. F., Siu, L. L., Holsinger, F. C., El-Naggar, A., Chung, C., Cmelak, A., Burtness, B., Bednarz, G., Quon, H., Breen, S. L., Gwede, C. K., Dicker, A. P., Yao, M., Jordan, R. C., Dorth, J., Lee, N., Chan, J. W., … NRG Oncology RTOG 0920 Collaborating Team (2025). Postoperative Radiotherapy ± Cetuximab for Intermediate-Risk Head and Neck Cancer. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 43(12), 1474–1487. https://doi.org/10.1200/JCO-24-01829
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
39841939
Department(s)
Administration and Leadership
Document Type
Article