Treatment response lowers tumor symptom burden in recurrent and/or metastatic head and neck cancer

BMC Cancer

Rainer Fietkau¹  Markus Hecht¹  Steffi Weniger²  Manfred Welslau³  Dennis Hahn⁴  Panagiotis Balermpas⁵  Jens von der Grün⁵  Claus Belka⁶  Dietmar Reichert⁷  Katrin Orlowski⁸  Karsten G. Stenzel⁸  Thomas Göhler⁹  Diethelm Messinger^1,10  Tobias Bergmann^1,11  Orlando Guntinas-Lichius^1,12  Philipp Wolber^1,13  Matthias G. Hautmann^1,14  Christina Große-Thie^1,15 

[1] Department of Radiation Oncology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstraße 27, 91054, Erlangen, Germany;Gemeinschaftspraxis Dres. Weniger/Bittrich, Erfurt, Germany;Klinikum Aschaffenburg, Hämato-Onkologische Schwerpunktpraxis, Aschaffenburg, Germany;Klinikum Stuttgart, Klinik für Onkologie, Stuttgart, Germany;Klinikum der J.-W. Goethe-Universität Frankfurt a.M., Klinik für Strahlentherapie und Onkologie, Frankfurt, Germany;Klinikum der Universität München (A.ö.R.), Klinik für Strahlentherapie und Radioonkologie, Munich, Germany;Medizinische Studiengesellschaft NORD-WEST GmbH, Westerstede, Germany;Merck Serono GmbH, Medical Affairs Oncology, Darmstadt, Germany;Onkozentrum Dresden/Freiberg, Dresden, Germany;Prometris GmbH, Mannheim, Germany;SRH Wald-Klinikum Gera GmbH, II. Medizinische Klinik, Gera, Germany;Universitätsklinikum Jena, Klinik für Hals-Nasen- und Ohrenheilkunde, Jena, Germany;Universitätsklinikum Köln, Klinik für Hals-, Nasen- und Ohrenheilkunde, Köln, Germany;Universitätsklinikum Regensburg, Klinik und Poliklinik für Strahlentherapie, Regensburg, Germany;Universitätsmedizin Rostock, Zentrum Innere Medizin Klinik III – Hämatologie, Onkologie, Palliativmedizin, Rostock, Germany;

关键词: Symptom;    Response;    HNSCC;    Cetuximab;    Chemotherapy;   

DOI  :  10.1186/s12885-020-07440-w

来源: Springer

【 摘 要 】

BackgroundHead and neck squamous cell cancer (HNSCC) frequently causes severe symptoms that may be reduced, when the tumor is successfully treated. The SOCCER trial studied the association of treatment response with patient reported tumor symptom burden in first line treatment of recurrent and/or metastatic HNSCC.MethodsIn this prospective, multi-center, non-interventional trial patients were treated either with platinum-based chemotherapy and cetuximab or radiotherapy and cetuximab. Tumor symptom burden was assessed every four weeks with a questionnaire containing ten visual analogue scales (VAS, range 0–100), which were summarized to the overall VAS score.ResultsFourhundred seventy patients were registered in 97 German centers. A total of 315 patients with at least the baseline and one subsequent questionnaire were available for analysis. Changes in the VAS score were rated as absolute differences from baseline. Negative values indicate improvement of symptoms. The overall VAS score improved significantly at the first post-baseline assessment in responders (− 2.13 vs. non-responders + 1.15, p = 0.048), and even more for the best post-baseline assessment (− 7.82 vs. non-responders − 1.97, p = 0.0005). The VAS for pain (− 16.37 vs. non-responders − 8.89, p = 0.001) and swallowing of solid food (− 16.67 vs. non-responders − 5.06, p = 0.002) improved significantly more in responders (best post-baseline assessment). In the multivariable Cox regression analysis, worse overall VAS scores were associated with worse overall survival (hazard ratio for death 1.12 per 10 points increment on the overall VAS scale, 95% CI 1.05–1.20, p = 0.0009).ConclusionIn unselected patients beyond randomized controlled trials, treatment response lowers tumor symptom burden in recurrent and/or metastatic HNSCC.Trial registrationClinicalTrials.gov, NCT00122460. Registered 22 Juli 2005,

【 授权许可】

CC BY