Rudat V, Stadler P, Becker A, Vanselow B, Dietz A, Wannenmacher M, Molls M, Dunst J, Feldmann H J
Department of Radiooncology, University of Heidelberg, Germany.
Strahlenther Onkol. 2001 Sep;177(9):462-8. doi: 10.1007/pl00002427.
The purpose of this analysis was to evaluate the potential of the tumor oxygenation by means of Eppendorf pO2 histography as a predictive test to select patients for treatment alternatives.
Pretreatment tumor pO2 histographies of locoregional lymph node metastases were assessed in 194 patients with squamous cell carcinoma of the head and neck. Included in the analysis were 134 patients who received a primary radio- or radiochemotherapy with a radiation dose of > or = 60 Gy, and who had no distant metastasis at beginning of the therapy.
The Cox regression analysis revealed the fraction of pO2 values < or = 2.5 mm Hg (p = 0.004), age (p = 0.04) and radiotherapy/radiochemotherapy (p = 0.03) as significant independent prognostic factors for the survival. The positive and negative predictive values were calculated using different cut-off values of the fraction of pO2 values < or = 2.5 mm Hg and the survival status at 1 or 2 years after beginning of the therapy as endpoint. The highest positive and negative predictive values of all cut-off values were 0.50 and 0.41 at 1 year, and 0.81 and 0.26 at 2 years.
Our data confirm the influence of the tumor oxygenation on the prognosis of patients with squamous cell carcinoma of the head and neck after radiotherapy. However, the calculated positive and negative predictive values suggest that the pO2 histography alone is not sufficient to be used as a predictive test to successfully select patients for treatment alternatives.
本分析的目的是评估通过Eppendorf氧分压组织成像术评估肿瘤氧合情况作为一种预测性检测方法,以选择适合不同治疗方案的患者的潜力。
对194例头颈部鳞状细胞癌患者局部区域淋巴结转移灶的治疗前肿瘤氧分压组织成像进行评估。分析纳入了134例接受初始放疗或放化疗(放疗剂量≥60 Gy)且治疗开始时无远处转移的患者。
Cox回归分析显示,氧分压值≤2.5 mmHg的比例(p = 0.004)、年龄(p = 0.04)以及放疗/放化疗(p = 0.03)是生存的显著独立预后因素。以治疗开始后1年或2年的生存状态为终点,使用氧分压值≤2.5 mmHg比例的不同临界值计算阳性和阴性预测值。所有临界值中,1年时最高的阳性和阴性预测值分别为0.50和0.41,2年时分别为0.81和0.26。
我们的数据证实了肿瘤氧合对放疗后头颈部鳞状细胞癌患者预后的影响。然而,计算得出的阳性和阴性预测值表明,仅靠氧分压组织成像不足以作为一种预测性检测方法来成功选择适合不同治疗方案的患者。