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


Journal

BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800

Informations de publication

Date de publication:
29 Sep 2020
Historique:
received: 30 05 2020
accepted: 21 09 2020
entrez: 30 9 2020
pubmed: 1 10 2020
medline: 15 4 2021
Statut: epublish

Résumé

Head 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. In 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. Fourhundred 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). In unselected patients beyond randomized controlled trials, treatment response lowers tumor symptom burden in recurrent and/or metastatic HNSCC. ClinicalTrials.gov, NCT00122460 . Registered 22 Juli 2005.

Sections du résumé

BACKGROUND BACKGROUND
Head 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.
METHODS METHODS
In 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.
RESULTS RESULTS
Fourhundred 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).
CONCLUSION CONCLUSIONS
In unselected patients beyond randomized controlled trials, treatment response lowers tumor symptom burden in recurrent and/or metastatic HNSCC.
TRIAL REGISTRATION BACKGROUND
ClinicalTrials.gov, NCT00122460 . Registered 22 Juli 2005.

Identifiants

pubmed: 32993574
doi: 10.1186/s12885-020-07440-w
pii: 10.1186/s12885-020-07440-w
pmc: PMC7526421
doi:

Substances chimiques

Antibodies, Monoclonal, Humanized 0
Platinum 49DFR088MY
Cetuximab PQX0D8J21J
Cisplatin Q20Q21Q62J

Banques de données

ClinicalTrials.gov
['NCT00122460']

Types de publication

Clinical Trial Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

933

Références

N Engl J Med. 2016 Nov 10;375(19):1856-1867
pubmed: 27718784
Radiother Oncol. 2018 Sep;128(3):467-471
pubmed: 29784451
Ann Oncol. 2010 Oct;21(10):1967-1973
pubmed: 20335368
Strahlenther Onkol. 2018 Aug;194(8):727-736
pubmed: 29556677
Strahlenther Onkol. 2019 Jun;195(6):496-503
pubmed: 30877351
Laryngoscope. 2017 Jan;127(1):127-133
pubmed: 27392821
N Engl J Med. 2008 Sep 11;359(11):1116-27
pubmed: 18784101
Strahlenther Onkol. 2015 Aug;191(8):656-64
pubmed: 26004121

Auteurs

Markus Hecht (M)

Department of Radiation Oncology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstraße 27, 91054, Erlangen, Germany. markus.hecht@uk-erlangen.de.

Dennis Hahn (D)

Klinikum Stuttgart, Klinik für Onkologie, Stuttgart, Germany.

Philipp Wolber (P)

Universitätsklinikum Köln, Klinik für Hals-, Nasen- und Ohrenheilkunde, Köln, Germany.

Matthias G Hautmann (MG)

Universitätsklinikum Regensburg, Klinik und Poliklinik für Strahlentherapie, Regensburg, Germany.

Dietmar Reichert (D)

Medizinische Studiengesellschaft NORD-WEST GmbH, Westerstede, Germany.

Steffi Weniger (S)

Gemeinschaftspraxis Dres. Weniger/Bittrich, Erfurt, Germany.

Claus Belka (C)

Klinikum der Universität München (A.ö.R.), Klinik für Strahlentherapie und Radioonkologie, Munich, Germany.

Tobias Bergmann (T)

SRH Wald-Klinikum Gera GmbH, II. Medizinische Klinik, Gera, Germany.

Thomas Göhler (T)

Onkozentrum Dresden/Freiberg, Dresden, Germany.

Manfred Welslau (M)

Klinikum Aschaffenburg, Hämato-Onkologische Schwerpunktpraxis, Aschaffenburg, Germany.

Christina Große-Thie (C)

Universitätsmedizin Rostock, Zentrum Innere Medizin Klinik III - Hämatologie, Onkologie, Palliativmedizin, Rostock, Germany.

Orlando Guntinas-Lichius (O)

Universitätsklinikum Jena, Klinik für Hals-Nasen- und Ohrenheilkunde, Jena, Germany.

Jens von der Grün (J)

Klinikum der J.-W. Goethe-Universität Frankfurt a.M., Klinik für Strahlentherapie und Onkologie, Frankfurt, Germany.

Panagiotis Balermpas (P)

Klinikum der J.-W. Goethe-Universität Frankfurt a.M., Klinik für Strahlentherapie und Onkologie, Frankfurt, Germany.

Katrin Orlowski (K)

Merck Serono GmbH, Medical Affairs Oncology, Darmstadt, Germany.

Diethelm Messinger (D)

Prometris GmbH, Mannheim, Germany.

Karsten G Stenzel (KG)

Merck Serono GmbH, Medical Affairs Oncology, Darmstadt, Germany.

Rainer Fietkau (R)

Department of Radiation Oncology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstraße 27, 91054, Erlangen, Germany.

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Classifications MeSH