POTENTIAL DOUBLING TIME IN HEAD AND NECK TUMORS TREATED BY PRIMARY RADIOTHERAPY - PRELIMINARY EVIDENCE FOR A PROGNOSTIC-SIGNIFICANCE IN LOCAL-CONTROL

被引：47

作者：

CORVO, R ^{[1
]}

GIARETTI, W ^{[1
]}

SANGUINETI, G ^{[1
]}

GEIDO, E ^{[1
]}

ORECCHIA, R ^{[1
]}

BARRA, S ^{[1
]}

MARGARINO, G ^{[1
]}

BACIGALUPO, A ^{[1
]}

VITALE, V ^{[1
]}

机构：

[1] IST NAZL RIC CANC, DIV ONCOL CHIRURG, GENOA, ITALY

来源：

INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 1993年 / 27卷 / 05期

关键词：

CELL KINETICS; HEAD AND NECK TUMORS; POTENTIAL DOUBLING TIME; BROMODEOXYURIDINE; FLOW-CYTOMETRY;

D O I：

10.1016/0360-3016(93)90539-8

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: The aim of the study was to determine preliminarily whether cell kinetic parameters evaluated using in vivo infusion of bromodeoxyuridine (BrdUrd) and flow cytometry, play a role as prognostic factors of loco-regional control in squamous cell head and neck carcinoma treated with radiotherapy. Methods and Materials: Between April 1989 and December 1991, 42 patients with unresectable Stage II-IV squamous cell carcinoma of the oral cavity, pharynx or larynx were given an infusion of BrdUrd solution prior to primary tumor biopsy sampling at 4-6 hr later. The simultaneous labeling S-phase fraction (LI) and duration (Ts) as well as the estimated potential doubling time (Tpot) were measured using flow cytometric analysis of BrdUrd and DNA content. Twenty-six patients received standard radiotherapy (70 Gy/35 fractions/7 weeks) whereas 15 patients were treated with the concomitant boost technique (75 Gy/40 fractions/6 weeks). Results: A complete set of flow cytometric data was available for 31 patients. The median value of LI, Ts, and Tpot were 9%, 9 hr and 5 days, respectively. Univariate analysis among the patients treated homogeneously by standard radiotherapy, indicated that local control was affected by Tpot value (p = 0.02). When the same analysis was performed for the patients treated with either standard radiotherapy or concomitant boost regimen, we found a p = 0.04. Thus, patients with a tumor Tpot value less-than-or-equal-to 5 days had a significantly lower three-year local control than patients with Tpot > 5 days. Log-rank test univariate analysis showed, in addition, that nodal status was the strongest prognostic factor of local control (p = 0.005). Age, tumor stage, tumor site, performance status, grading, radiotherapy regimen, DNA ploidy and LI value were, instead, not significantly related to loco-regional control. Finally, when comparing the type of radiotherapy for tumors with Tpot less-than-or-equal-to 5 days, we found a trend toward a better local control after concomitant boost regimen, with respect to standard regimen (p = 0.06). Conclusion: The present preliminary results suggest that Tpot could play a role as additional prognostic factor influencing the disease outcome in head and neck carcinoma treated by radiotherapy.

引用

页码：1165 / 1172

页数：8

共 38 条

[1]

Ang, Peters, Weber, Maor, Morrison, Wendt, Brown, Concomitant boost radiotherapy schedules in the treatment of the oropharynx and nasopharynx, Int. J. Radiat. Oncol. Biol. Phys., 19, pp. 1339-1345, (1990)

[2]

Begg, Hofland, Kummermehr, Tumor cell repopulation during fractionated radiotherapy: Correlation between flow cytometric and radiobiological data in three murine tumours, Eur. J. Cancer, 27, pp. 537-543, (1991)

[3]

Begg, Hofland, Van Glabekke, Bartelink, Horiot, Predictive value of potential doubling time for radiotherapy of head and neck tumor patients: Results from the EORTC Cooperative Trial 22851, Sem. Radiat. Oncol., 2, pp. 22-25, (1992)

[4]

Begg, McNally, Shrieve, Karcher, A method to measure the duration of the DNA synthesis and the potential doubling time from a single sample, Cytometry, 6, pp. 620-626, (1985)

[5]

Bentzen, Johansen, Overgaard, Thames, Clinical radiobiology of squamous cell carcinoma of the oropharynx, Int. J. Radiat. Oncol. Biol. Phys., 20, pp. 1197-1206, (1991)

[6]

Bruno, Di Vinci, Geido, Giaretti, Cell cycle synchronization induced by tamoxifen and 17-B estradiol on MCF-7 cells using flow cytometry and a monoclonal antibody against bromodeoxyuridine, Breast Cancer Res. Treat., 11, pp. 221-229, (1988)

[7]

Dolbeare, Gratzner, Pallavicini, Gray, Flow cytometry measurement of total DNA content and incorporated bromodeoxyuridine, Proc. Natl. Acad. Sci. USA, 80, pp. 5573-5777, (1983)

[8]

Fowler, Potential for increasing the differential response between tumours and normal tissue: Can proliferation rate be used?, Int. J. Radiat. Oncol. Biol. Phys., 12, pp. 641-645, (1985)

[9]

Fowler, How worthwhile are short schedules in radiotherapy? A series of exploratory calculations, Radiother. Oncol., 18, pp. 15-18, (1990)

[10]

Fowler, Lindstrom, Loss of local control with prolongation in radiotherapy, Int. J. Radiat. Oncol. Biol. Phys., 23, pp. 457-467, (1992)

← 1 2 3 4 →