• 2/2/2007
  • New York, NY
  • Megan Rauscher
  • CancerPage.com

In a retrospective case-control study, researchers observed a non-significant trend for better survival in head and neck cancer patients who used nonselective COX inhibitors (aspirin and/or nonsteroidal anti-inflammatory medications) on a regular basis.

“Although these results are intriguing, there is not sufficient evidence to recommend their use in patients with head and neck cancer unlike patients with colon polyps or colon cancer,” Dr. M. Boyd Gillespie from the Medical University of South Carolina warned in comments to Reuters Health.

For the study, reported in the January issue of the Archives of Otolaryngology–Head and Neck Surgery, Dr. Gillespie and colleagues identified 325 head and neck squamous cell carcinoma patients. They compared the rate of COX inhibitor use among patients who had died or whose disease had recurred with that among survivors or those without recurrence.

Medication data were available for 319 subjects, of whom 232 (73%) were COX inhibitor users and 87 (27%) were nonusers.

There was no difference in COX inhibitor exposure between patients with and without disease recurrence (p = 0.42). “Although non-selective COX inhibitors are inexpensive, widely available, and relatively safe, they do not appear to have a strong effect at preventing recurrences of head and neck cancer,” Dr. Gillespie said.

There was also no significant difference in COX inhibitor use between survivors and nonsurvivors of head and neck cancer (p = 0.66). Nevertheless, there was a trend toward longer survival with regular COX inhibitor use. The median survival of COX inhibitor users was 96 months compared with 47 months in nonusers.

“A randomized, double-blinded controlled trial is needed to determine if COX inhibitors are an effective chemopreventive therapy in patients with head and neck cancer,” the authors conclude. \]

“Future clinical trials,” Dr. Gillespie added, “should involve the use of selective COX-2 inhibitors; however the patients will have to be carefully selected and monitored given the known risk of cardiac toxicity.”

Source:
Arch Otolaryngol Head Neck Surg 2007;133:28-31