Björk-Eriksson T, West C, Karlsson E, Mercke C
Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden.
Int J Radiat Oncol Biol Phys. 2000 Jan 1;46(1):13-9. doi: 10.1016/s0360-3016(99)00373-9.
To evaluate prospectively the prognostic value of SF2 for local control and survival in patients undergoing radiation therapy for head and neck cancers.
Following informed consent tumor specimens were obtained from 156 patients with primary carcinomas of the head and neck region. The specimens were assessed for the ability to grow in vitro (colony forming efficiency, CFE) and inherent radiosensitivity measured as the surviving fraction at 2 Gy (SF2) using a soft-agar clonogenic assay. Patients were treated mainly with neoadjuvant chemotherapy plus radiation therapy usually as a combination of accelerated external beam and interstitial radiotherapy. The probabilities of local control and survival were analyzed by univariate, bivariate and Cox multivariate analyses.
Successful growth was achieved in 110/156 specimens and SF2 values were obtained from 99/156. Eighty four out of these patients underwent radical treatment. The median SF2 value for the 84 tumors was 0.40. At a mean follow-up time of 25 months (range 7-65) the median SF2 value of tumors from 14 patients who developed local recurrence was 0.53, which was significantly higher than the median of 0.38 for tumors from 70 patients without local recurrence (p = 0.015). Tumor SF2 was a significant prognostic factor for local control (p = 0.036), but not for overall survival (p = 0.20). Tumor SF2 was an independent prognostic factor for local control within bivariate and Cox multivariate analyses.
This study has shown that tumor radiosensitivity measured as SF2 is a significant prognostic factor for local control in head and neck cancers.
前瞻性评估SF2对头颈部癌放疗患者局部控制和生存的预后价值。
在获得知情同意后，从156例头颈部原发性癌患者中获取肿瘤标本。使用软琼脂克隆形成试验评估标本的体外生长能力（集落形成效率，CFE）以及以2 Gy时的存活分数（SF2）衡量的固有放射敏感性。患者主要接受新辅助化疗加放疗，通常采用加速外照射和组织间放疗相结合的方式。通过单因素、双因素和Cox多因素分析来分析局部控制和生存的概率。
110/156例标本成功生长，99/156例获得了SF2值。其中84例患者接受了根治性治疗。84个肿瘤的SF2值中位数为0.40。在平均随访时间25个月（范围7 - 65个月）时，14例发生局部复发患者的肿瘤SF2值中位数为0.53，显著高于70例无局部复发患者肿瘤的中位数0.38（p = 0.015）。肿瘤SF2是局部控制的显著预后因素（p = 0.036），但不是总生存的预后因素（p = 0.20）。在双因素和Cox多因素分析中，肿瘤SF2是局部控制的独立预后因素。
本研究表明，以SF2衡量的肿瘤放射敏感性是头颈部癌局部控制的显著预后因素。
