TY - JOUR
T1 - Infectious Complications in Head and Neck Cancer Patients Treated with Cetuximab
T2 - Propensity Score and Instrumental Variable Analysis
AU - Lee, Ching Chih
AU - Ho, Hsu Chueh
AU - Hsiao, Shih Hsuan
AU - Huang, Tza Ta
AU - Lin, Hon Yi
AU - Li, Szu Chin
AU - Chou, Pesus
AU - Su, Yu Chieh
PY - 2012/11/28
Y1 - 2012/11/28
N2 - Background: To compare the infection rates between cetuximab-treated patients with head and neck cancers (HNC) and untreated patients. Methodology: A national cohort of 1083 HNC patients identified in 2010 from the Taiwan National Health Insurance Research Database was established. After patients were followed for one year, propensity score analysis and instrumental variable analysis were performed to assess the association between cetuximab therapy and the infection rates. Results: HNC patients receiving cetuximab (n = 158) were older, had lower SES, and resided more frequently in rural areas as compared to those without cetuximab therapy. 125 patients, 32 (20.3%) in the group using cetuximab and 93 (10.1%) in the group not using it presented infections. The propensity score analysis revealed a 2.3-fold (adjusted odds ratio [OR] = 2.27; 95% CI, 1.46-3.54; P = 0.001) increased risk for infection in HNC patients treated with cetuximab. However, using IVA, the average treatment effect of cetuximab was not statistically associated with increased risk of infection (OR, 0.87; 95% CI, 0.61-1.14). Conclusions: Cetuximab therapy was not statistically associated with infection rate in HNC patients. However, older HNC patients using cetuximab may incur up to 33% infection rate during one year. Particular attention should be given to older HNC patients treated with cetuximab.
AB - Background: To compare the infection rates between cetuximab-treated patients with head and neck cancers (HNC) and untreated patients. Methodology: A national cohort of 1083 HNC patients identified in 2010 from the Taiwan National Health Insurance Research Database was established. After patients were followed for one year, propensity score analysis and instrumental variable analysis were performed to assess the association between cetuximab therapy and the infection rates. Results: HNC patients receiving cetuximab (n = 158) were older, had lower SES, and resided more frequently in rural areas as compared to those without cetuximab therapy. 125 patients, 32 (20.3%) in the group using cetuximab and 93 (10.1%) in the group not using it presented infections. The propensity score analysis revealed a 2.3-fold (adjusted odds ratio [OR] = 2.27; 95% CI, 1.46-3.54; P = 0.001) increased risk for infection in HNC patients treated with cetuximab. However, using IVA, the average treatment effect of cetuximab was not statistically associated with increased risk of infection (OR, 0.87; 95% CI, 0.61-1.14). Conclusions: Cetuximab therapy was not statistically associated with infection rate in HNC patients. However, older HNC patients using cetuximab may incur up to 33% infection rate during one year. Particular attention should be given to older HNC patients treated with cetuximab.
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U2 - 10.1371/journal.pone.0050163
DO - 10.1371/journal.pone.0050163
M3 - Article
C2 - 23209663
AN - SCOPUS:84870361987
SN - 1932-6203
VL - 7
JO - PloS one
JF - PloS one
IS - 11
M1 - e50163
ER -