The use of nonsteroidal anti-inflammatory drugs (NSAIDS) in patients with head and neck squamous cell carcinoma (HNSCC) is significantly associated with better overall survival (OS) at 5 years compared to no use of NSAIDS, a study published in JAMA Network Open finds.
Patients with HNSCC were treated with chemoradiation therapy between January 2005 and August 2017. Primary outcome measures were the association of NSAID use with patterns of failure, disease-specific survival (DSS), and OS.
Of 460 patients, 201 (43.7%) were taking NSAIDs during treatment, either as low-dose 81-mg aspirin daily (n=109) (53.7%), high-dose 325-mg aspirin daily (n=22) (10.9%), or other NSAIDs (ibuprofen, naproxen, or meloxicam) (n=70) (34.8%).
Univariate analysis showed that NSAID use was associated with better overall survival (hazard ratio [HR], 0.63; 95% CI, 0.43-0.92; P = 0.02), which remained significant after adjusting for confounding factors (age, smoking status, primary tumour site, HPV status, diabetes, stroke and hyperlipidaemia) (HR, 0.59; 95% CI, 0.38-0.90; P = 0.02).
NSAID use was not associated with better DSS, a better response to treatment, or with distant failure. Both in the univariate and multivariate analysis, current smokers vs former or never smokers had significantly worse local control (LC) (absence of disease within the initial treatment volumes).