Treatment of Head and Neck Cancer—Sometimes, Less Is More

In this issue of JAMA Otolaryngology-Head & Neck Surgery, Saraswathula and colleagues¹ used the Surveillance, Epidemiology, and End Results Program (SEER)–Medicare outcomes and claims database to compare the value of 3 different radiotherapy (RT) regimens (ie, RT alone, RT plus cisplatin, or RT plus cetuximab) administered to patients older than 65 years with locally advanced head and neck cancer (HNC) of the oral cavity, oropharynx, larynx, and hypopharynx. In this setting, RT plus cetuximab was not associated with improved survival compared with RT alone, but it was associated with an increased number of emergency department visits and increased costs. The authors concluded that cetuximab concurrently administered with RT seems to be of low value in terms of improved survival and higher costs for older patients with HNC.