Efficacy Of Cetuximab In The Treatment Of Locally Advanced Head And Neck Squamous Cell Carcinoma: A Meta-analysis

Objective:to evaluate the potential application of cetuximab in standard treatment by comparing the incidence of toxic side effects,local control rate,disease free survival and overall survival time in patients with locally advanced head and neck squamous cell carcinoma treated by standard therapy with or without cetuximab.Methods: search for sentences and keywords in Pubmed,Embase and Cochrane Library.The statistical analysis of the outcome variables was carried out by the Meta analysis of the survival data.Results: 782 articles were retrieved through the search strategy,and the final 10 papers were included in the Meta analysis,with a total sample size of 2466.Compared with the standard treatment group,the OR of toxic and side effects of cetuximab plus standard treatment group was 1.036(95%CI 0.889,1.207,P=0.598);HR of local control rate was 1.122(95%CI 0.906,1.339),P=0.285;HR of disease free survival was 1.122(95%CI 0.906,1.339),P=0.129;HR of overall survival was 0.87(95%CI 0.72,1.02),P=0.068.The overall survival rate was analyzed by subgroup analysis according to the research category.HR of clinical trial(Type=1)was 0.824(95%CI 0.670,0.977),and the 2 year overall survival rate and the 3 year overall survival rate could directly benefit 3.87% and 3.34% respectively from cetuximab.HR of retrospective cohort study(Type=0)was 1.614(95%CI 1.001,2.227).Conclusion: compared with the standard treatment group,the addition of cetuximab has a positive effect on the overall survival of patients with locally advanced head and neck squamous cell carcinoma,and this positive effect is more prominent in clinical trials.At the same time,the addition of cetuximab did not aggravate three or four levels of toxic and side effects.