Highlights
- •There are limited prospective studies on systemic therapy for advanced cutaneous squamous cell carcinoma.
- •Cisplatin-based chemotherapy is not always superior to other drugs.
- •RCT improves overall survival in patients with nodal squamous cell carcinoma.
Abstract
Background
Cutaneous squamous cell carcinoma (cSCC) is the second most common type of skin cancer.
Few patients with cSCC experience metastases, but the prognosis of advanced cSCC (acSCC)
is dismal. Evidence regarding systemic therapy for acSCC is limited. Therefore, we
aimed to determine the most effective systemic treatment for acSCC.
Patients and methods
This retrospective study involved 16 Japanese institutions. We documented patient
and tumour characteristics and disease course of patients with acSCC who received
systemic therapy between 1st January 2006 and 31st December 2015. We compared the
overall survival (OS) and progression-free survival (PFS) for (1) platinum versus non-platinum
groups, (2) radiation plus chemotherapy first-line therapy (RCT) versus non-RCT groups and
(3) platinum-based RCT versus non–platinum-based RCT groups.
Results
Although the use of platinum-based systemic therapy was not associated with statistically
significant improvements in PFS and OS, there were significant differences between
the RCT and non-RCT groups (PFS: p < 0.001, OS: p = 0.003). In the subgroup analysis,
RCT significantly prolonged PFS and OS in the nodal SCC (nSCC) group. For the RCT
and non-RCT groups, the median OS was 110 and 14 months, respectively, and the 5-year
OS rate was 54% and 21%, respectively.
Conclusion
RCT could improve OS in patients with nSCC. However, further multicenter prospective
studies are needed to establish evidence for superiority of RCT.
Keywords
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Article info
Publication history
Published online: January 28, 2020
Accepted:
December 17,
2019
Received in revised form:
November 26,
2019
Received:
June 17,
2019
Identification
Copyright
© 2019 Elsevier Ltd. All rights reserved.
