Tegafur-Uracil versus 5-Fluorouracil in Combination with Cisplatin and Cetuximab in Elderly Patients with Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma: A Propensity Score Matching Analysis
There are increasing incidences of elderly patients with recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC). However, the treatment is not yet established. We conducted a propensity score matching analysis to evaluate the efficacy and safety of tegafur–uracil versus 5-fluorour...
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MDPI AG
2021-10-01
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| Online Access: | https://www.mdpi.com/2079-7737/10/10/1011 |
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| author | Meng-Che Hsieh Chih-Chun Wang Chuan-Chien Yang Ching-Feng Lien Chien-Chung Wang Yu-Chen Shih Shyh-An Yeh Tzer-Zen Hwang |
| author_facet | Meng-Che Hsieh Chih-Chun Wang Chuan-Chien Yang Ching-Feng Lien Chien-Chung Wang Yu-Chen Shih Shyh-An Yeh Tzer-Zen Hwang |
| author_sort | Meng-Che Hsieh |
| collection | DOAJ |
| description | There are increasing incidences of elderly patients with recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC). However, the treatment is not yet established. We conducted a propensity score matching analysis to evaluate the efficacy and safety of tegafur–uracil versus 5-fluorouracil in combination with cisplatin plus cetuximab in elderly patients with R/M HNSCC. Elderly patients with R/M HNSCC treated with cetuximab-containing chemotherapy were recruited into this study. In order to reduce the selection bias, propensity score matching was performed. Kaplan–Meier curves were plotted for progression-free survival (PFS) and overall survival (OS). Toxicities were graded according to the National Cancer Institute’s Common Terminology Criteria V3.0. After propensity sore matching, 54 patients with tegafur–uracil, cisplatin plus cetuximab (UPEx), and 54 patients with 5-fluorouracil, cisplatin plus cetuximab (EXTREME) were identified. The median PFS was 5.4 months in UPEx and 5.8 months in EXTREME (<i>p</i> = 0.451). The median OS was 10.8 months in UPEx and 10.2 months in EXTREME (<i>p</i> = 0.807). The overall response rate (ORR) and disease control rate (DCR) were insignificant in both arms, accounting for 61% versus 59% (<i>p</i> = 0.680) and 72% versus 70% (<i>p</i> = 0.732) in the UPEx arm and the EXTREME arm, respectively. A multivariate analysis showed that age and ECOG PS were, independently, predictors. Grade 3/4 adverse events were much fewer in UPEx than in EXTREME (<i>p</i> < 0.001). Both cetuximab-containing chemotherapies are effective in elderly patients with R/M HNSCC. Safety profiles are improved when tegafur–uracil is substituted for 5-fluorouracil. Further prospective studies are warranted to validate our conclusions. |
| first_indexed | 2024-03-10T06:42:59Z |
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| id | doaj.art-015e0b855f3246c48535a4e958501534 |
| institution | Directory Open Access Journal |
| issn | 2079-7737 |
| language | English |
| last_indexed | 2024-03-10T06:42:59Z |
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| spelling | doaj.art-015e0b855f3246c48535a4e9585015342023-11-22T17:28:24ZengMDPI AGBiology2079-77372021-10-011010101110.3390/biology10101011Tegafur-Uracil versus 5-Fluorouracil in Combination with Cisplatin and Cetuximab in Elderly Patients with Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma: A Propensity Score Matching AnalysisMeng-Che Hsieh0Chih-Chun Wang1Chuan-Chien Yang2Ching-Feng Lien3Chien-Chung Wang4Yu-Chen Shih5Shyh-An Yeh6Tzer-Zen Hwang7Department of Hematology-Oncology, E-Da Cancer Hospital, Kaohsiung City 82445, TaiwanCollege of Medicine, I-Shou University, Kaohsiung City 82445, TaiwanCollege of Medicine, I-Shou University, Kaohsiung City 82445, TaiwanCollege of Medicine, I-Shou University, Kaohsiung City 82445, TaiwanCollege of Medicine, I-Shou University, Kaohsiung City 82445, TaiwanCollege of Medicine, I-Shou University, Kaohsiung City 82445, TaiwanCollege of Medicine, I-Shou University, Kaohsiung City 82445, TaiwanCollege of Medicine, I-Shou University, Kaohsiung City 82445, TaiwanThere are increasing incidences of elderly patients with recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC). However, the treatment is not yet established. We conducted a propensity score matching analysis to evaluate the efficacy and safety of tegafur–uracil versus 5-fluorouracil in combination with cisplatin plus cetuximab in elderly patients with R/M HNSCC. Elderly patients with R/M HNSCC treated with cetuximab-containing chemotherapy were recruited into this study. In order to reduce the selection bias, propensity score matching was performed. Kaplan–Meier curves were plotted for progression-free survival (PFS) and overall survival (OS). Toxicities were graded according to the National Cancer Institute’s Common Terminology Criteria V3.0. After propensity sore matching, 54 patients with tegafur–uracil, cisplatin plus cetuximab (UPEx), and 54 patients with 5-fluorouracil, cisplatin plus cetuximab (EXTREME) were identified. The median PFS was 5.4 months in UPEx and 5.8 months in EXTREME (<i>p</i> = 0.451). The median OS was 10.8 months in UPEx and 10.2 months in EXTREME (<i>p</i> = 0.807). The overall response rate (ORR) and disease control rate (DCR) were insignificant in both arms, accounting for 61% versus 59% (<i>p</i> = 0.680) and 72% versus 70% (<i>p</i> = 0.732) in the UPEx arm and the EXTREME arm, respectively. A multivariate analysis showed that age and ECOG PS were, independently, predictors. Grade 3/4 adverse events were much fewer in UPEx than in EXTREME (<i>p</i> < 0.001). Both cetuximab-containing chemotherapies are effective in elderly patients with R/M HNSCC. Safety profiles are improved when tegafur–uracil is substituted for 5-fluorouracil. Further prospective studies are warranted to validate our conclusions.https://www.mdpi.com/2079-7737/10/10/1011elderly patientsrecurrent or metastatic head and neck squamous cell carcinomategafur–uracilcetuximabsurvival |
| spellingShingle | Meng-Che Hsieh Chih-Chun Wang Chuan-Chien Yang Ching-Feng Lien Chien-Chung Wang Yu-Chen Shih Shyh-An Yeh Tzer-Zen Hwang Tegafur-Uracil versus 5-Fluorouracil in Combination with Cisplatin and Cetuximab in Elderly Patients with Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma: A Propensity Score Matching Analysis Biology elderly patients recurrent or metastatic head and neck squamous cell carcinoma tegafur–uracil cetuximab survival |
| title | Tegafur-Uracil versus 5-Fluorouracil in Combination with Cisplatin and Cetuximab in Elderly Patients with Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma: A Propensity Score Matching Analysis |
| title_full | Tegafur-Uracil versus 5-Fluorouracil in Combination with Cisplatin and Cetuximab in Elderly Patients with Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma: A Propensity Score Matching Analysis |
| title_fullStr | Tegafur-Uracil versus 5-Fluorouracil in Combination with Cisplatin and Cetuximab in Elderly Patients with Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma: A Propensity Score Matching Analysis |
| title_full_unstemmed | Tegafur-Uracil versus 5-Fluorouracil in Combination with Cisplatin and Cetuximab in Elderly Patients with Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma: A Propensity Score Matching Analysis |
| title_short | Tegafur-Uracil versus 5-Fluorouracil in Combination with Cisplatin and Cetuximab in Elderly Patients with Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma: A Propensity Score Matching Analysis |
| title_sort | tegafur uracil versus 5 fluorouracil in combination with cisplatin and cetuximab in elderly patients with recurrent or metastatic head and neck squamous cell carcinoma a propensity score matching analysis |
| topic | elderly patients recurrent or metastatic head and neck squamous cell carcinoma tegafur–uracil cetuximab survival |
| url | https://www.mdpi.com/2079-7737/10/10/1011 |
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