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

[11]

Fu, Phillips, Silverberg, Jacobs, Goffinet, Chun, Friedman, Wohler, McWhirter, Carter, Combined radiotherapy and chemotherapy with bleomycin and metotrexate for advanced inoperable head and neck cancer: Update of a northern California Oncology Group randomized trial, J. Clin. Oncol., 5, pp. 1410-1418, (1987)

[12]

Giaretti, Ploidy and proliferation evaluated by flow cytometry. An overview of techniques and impact in oncology, Tumori, 77, pp. 403-419, (1992)

[13]

Giaretti, Di Vinci, Geido, Marsano, Minks, Bruno, Measurement of C-myc protein content and cell cycle kinetics of normal and spontaneously transformed murine mastocytes by bivariate flow cytometry, Cell Tissue Kinet., 23, pp. 473-485, (1990)

[14]

Giaretti, Santi, Tumor progression by DNA flow cytometry in human colo-rectal cancer, Int. J. Cancer, 45, pp. 597-603, (1990)

[15]

Hemmer, Kreidler, Flow cytometric DNA ploidy analysis of squamous cell carcinoma of the oral cavity, Cancer, 66, pp. 317-320, (1990)

[16]

Hiddemann, Schumann, Andreeff, Barlagie, Herman, Leif, Mayall, Murphy, Sandberg, Convention on nomenclature for DNA cytometry, Cancer Genet. Cytogenet., 134, pp. 181-183, (1984)

[17]

Kaplan, Meier, Non parametric estimation from incomplete observations, Journal of the American Statistical Association, 53, pp. 457-481, (1958)

[18]

Lochrin, Wilson, McNally, Dische, Saunders, Tumor cell kinetics, local control and accelerated radiotherapy: A preliminary report, Int. J. Radiat. Oncol. Biol. Phys., 24, pp. 87-91, (1992)

[19]

Mantel, Evaluation of survival data and two new rank order statistics arising in its consideration, Cancer Chemother Rep, 50, pp. 163-170, (1966)

[20]

Merlano, Vitale, Rosso, Benasso, Corvo, Cavallari, Sanguineti, Bacigalupo, Badellino, Margarino, Brema, Pastorino, Marziano, Grimaldi, Scasso, Sperati, Pallestrini, Garaventa, Accomando, Cordone, Comella, Daponte, Rubagotti, Bruzzi, Santi, Treatment of advanced squamous cell carcinoma of the head and neck with alternating chemotherapy and radiotherapy, N. Eng. J. Med., 327, pp. 1115-1121, (1992)

← 1 2 3 4 →