Introduction

Squamous cell carcinomas of the head and neck (SCCHN) account for approximately 4% of all malignancies and are associated with high morbidity and poor prognosis. For patients who are not eligible for surgery or radiotherapy, treatment options are limited, especially for those with recurrent or metastatic (R/M) disease. Current European guidelines recommend first-line (1L) treatment with palliative chemotherapy, using biologic or platinum-based regimens. In the absence of new clinical trials in SCCHN, the use of real-world data has facilitated the assessment of treatment patterns and outcomes in different healthcare systems. This study reports on the 1L treatment of platinum-eligible patients with R/M SCCHN in Italy and Spain.

Methods

A point-in-time survey of the management of patients with R/M SCCHN was completed by clinical oncologists in Italy and Spain between October 2018 and February 2019. Patient demographics and clinical characteristics were obtained by retrospective chart review, whilst participating patients self-reported the impact of their disease on their quality of life (QoL) and well-being.

Results

A total of 436 patients were recruited from Italy (216) and Spain (220). Patient demographics for both countries comprised mostly male patients, aged 65 years in Italy and 63 in Spain on average. The primary site for the SCCHN was the pharynx and 36% of patients had metastatic disease overall. EXTREME or cetuximab-based regimens were the most common treatments administered at 1L (52% in Italy and 78% in Spain). Scores on the FACT-G in both countries were substantially lower than those of the general and other advanced cancer populations, while scores on the EQ-5D were clinically meaningfully lower than local population norms.

Conclusion

Despite 1L treatment of platinum-eligible patients with R/M SCCHN in Italy and Spain following current European guidelines, patients’ QoL remains poor, which highlights the need for alternative treatments that could improve clinical outcomes.

中文翻译：

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头颈癌患者的真实治疗模式和结果：意大利和西班牙肿瘤学家的时间点调查

介绍

头颈部鳞状细胞癌 (SCCHN) 约占所有恶性肿瘤的 4%，与高发病率和不良预后相关。对于不符合手术或放疗条件的患者，治疗选择是有限的，特别是对于复发或转移 (R/M) 疾病的患者。目前的欧洲指南推荐采用姑息性化疗的一线 (1L) 治疗，使用生物或铂类方案。在 SCCHN 中没有新的临床试验的情况下，使用真实世界的数据促进了对不同医疗保健系统的治疗模式和结果的评估。本研究报告了意大利和西班牙符合铂金条件的 R/M SCCHN 患者的 1L 治疗。

方法

2018 年 10 月至 2019 年 2 月期间，意大利和西班牙的临床肿瘤学家完成了 R/M SCCHN 患者管理的时间点调查。通过回顾性图表审查获得患者人口统计学和临床​​特征，同时参与患者自我报告了他们的疾病对他们的生活质量 (QoL) 和幸福感的影响。

结果

总共从意大利（216 名）和西班牙（220 名）招募了 436 名患者。这两个国家的患者人口统计数据主要包括男性患者，意大利平均年龄为 65 岁，西班牙平均年龄为 63 岁。SCCHN 的主要部位是咽部，36% 的患者总体上有转移性疾病。EXTREME 或基于西妥昔单抗的方案是最常见的 1L 治疗方案（意大利为 52%，西班牙为 78%）。在这两个国家，FACT-G 的分数大大低于一般和其他晚期癌症人群的分数，而 EQ-5D 的分数在临床上显着低于当地人群的标准。

结论

尽管意大利和西班牙按照当前的欧洲指南对符合铂金条件的 R/M SCCHN 患者进行了 1L 治疗，但患者的 QoL 仍然很差，这凸显了对可以改善临床结果的替代治疗的需求。