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M. Boyd Gillespie, MD; Marcus W. Moody, MD; Fu-Shing Lee, PhD; Lynn J. Poole, MD, PhD; Joshua D. Hornig, MD; Deanne Lathers, PhD; M. Rita Young, PhD; Terry A. Day, MD

Arch Otolaryngol Head Neck Surg. 2007;133(1):28-31.

Objective  To determine whether ongoing use of a cyclooxygenase (COX) inhibitor is associated with a reduction in mortality and disease recurrence after head and neck cancer treatment.

Design  Retrospective case-control study.

Patients  A total of 325 potential subjects with head and neck squamous cell carcinoma were identified using an electronic patient database.

Main Outcome Measure  The rate of COX inhibitor use among patients who had died or whose disease had recurred (cases) was compared with the rate of use among survivors or those without recurrence (controls). The comparison was controlled for tumor site, tumor stage, treatment received, age, sex, race, smoking, and alcohol use.

Results  The 325 patients were compared by logistic regressions, with recurrence rate and survival status as the dependent variables. There was no difference in COX inhibitor exposure between patients with recurrence and those with no recurrence (P = .42) or between survivors and those who died of disease (P = .66). The median survival of COX inhibitor users, however, was 96 months, compared with 47 months in nonusers. The only independent variable with a significant impact on recurrence and survival was tumor stage at the time of diagnosis.

Conclusions  Although preliminary in vitro studies suggest an antitumor effect of COX inhibitors in head and neck cancer, this study found no difference in head and neck cancer recurrence or survival in nonselective COX inhibitor users vs 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.

Author Affiliations: Departments of Otolaryngology–Head and Neck Surgery (Drs Gillespie, Moody, Lee, Poole, Hornig, Lathers, Young, and Day) and Medicine (Dr Young), Medical University of South Carolina, Charleston; and Department of Otolaryngology–Head and Neck Surgery (Drs Gillespie and Moody) and Research Service (Drs Young and Lathers), Ralph H. Johnson Veterans Affairs Medical Center, Charleston.