Radiation therapy for patients with newly diagnosed metastatic head and neck squamous cell carcinoma

Background To assess the association between radiation therapy (RT) use and overall survival (OS) for patients with metastatic head and neck squamous cell carcinomas (HNSCC). Methods We analyzed the National Cancer Database to identify patients with newly diagnosed metastatic HNSCC from 2004 to 2013 who were treated with up-front chemotherapy. Associations between the use of RT and OS were evaluated. Results We identified 3516 patients with metastatic HNSCC who were treated with chemotherapy; 2288 (65%) were also treated with RT. The addition of RT to chemotherapy was associated with prolonged survival (median: 13.6 vs 11.3 months, log-rank P < .001). After adjusting for other prognostic factors in a multivariable Cox model, propensity score matching and landmark analyses limited to patients who survived at least 3, 6, and 12 months after diagnosis, the use of RT remained associated with prolonged survival. Conclusion The addition of RT to chemotherapy in the up-front management of metastatic HNSCC was associated with prolonged OS in this study.