Serum CRP, ECOG scores, treatment intensity predict survival in metastatic SCCHN
Multivariable analysis of 128 cetuximab-treated SCCHN patients showed that a less intensive therapy was independently associated with worse overall survival (OS; hazard ratio [HR], 2.560; 95 percent CI, 1.510 to 4.341; p<0.001) than those who received polychemotherapy with cetuximab.
Similarly, high ECOG scores (HR, 2.048; 1.319 to 3.179; p=0.001), high CRP (HR, 1.651; 1.058 to 2.575; p=0.027) and leukocyte (HR, 2.224; 1.416 to 3.495; p=0.001) levels and shorter time from primary diagnosis to palliative therapy (HR, 1.830; 1.185 to 2.824; p=0.006) were independent predictors of poor prognosis.
A prognostic score for the patients was generated by assigning each of the five factors one point. Patients that had zero points had a median OS of 21.5 months.
In contrast, those with one, two, three, four and five points had median OS of 12.7, 6.8, 4.9, 0.7 and 0.6 months, respectively (p<0.001).
The median OS of patients with zero to one risk factor (13.6 months) was significantly greater than those with two to three risk factors (6.1 months; p<0.001) which, in turn, was significantly greater than those with four to five risk factors (0.7 months; p<0.001).
All participants recruited were diagnosed with metastatic or recurrent SCCHN and received either cetuximab alone or in combination with chemotherapy. Prognostic scores for OS were derived using measurements from serum samples and patient clinical characteristics.