Eriksen Jesper Grau, Steiniche Torben, Overgaard Jens
Department of Experimental Clinical Oncology, Aarhus University Hospital, Denmark.
Acta Oncol. 2005;44(1):50-8. doi: 10.1080/02841860510007396.
Reduction of the overall treatment time (OTT) of radiotherapy results in increased T-site control in squamous cell carcinomas of the head and neck (HNSCC). However, the response is heterogeneous and accelerated repopulation of clonogenic tumour cells during therapy may be one of the factors determining this response. The aim of the present study was to identify the influence of the epidermal growth factor receptor (EGFr) and E-cadherin for T-site control when the OTT was reduced and whether the markers add information to the histopathological grading in selecting patients for accelerated radiotherapy. A total of 209 patients from randomized DAHANCA-trials with supraglottic larynx squamous cell carcinomas treated with primary radiotherapy with different OTT of 9(1/2), 6(1/2), and 5(1/2) weeks. Available formalin-fixed paraffin embedded tumour tissues were re-evaluated for histopathological characteristics and stained for EGFr and E-cadherin. Data were correlated with patient and tumour characteristics and 5-year T-site control. EGFr and E-cadherin were not associated with patient or tumour characteristics except that EGFr correlated to carcinomas with a well to moderate histopathological feature. Tumours with high EGFr or low E-cadherin did benefit from reduced OTT, and the combination of the two (high EGFr and low E-cadherin) had the most significant acceleration of treatment effect, compared with tumours with other combinations of EGFr and E-cadherin expression. Tumours with high expression of EGFr and low expression of E-cadherin showed the most significant increase in T-site control when the overall treatment time of radiotherapy was reduced, and the markers may be useful for selecting patients who will benefit from accelerated radiotherapy.
缩短头颈部鳞状细胞癌(HNSCC)放疗的总治疗时间(OTT)可提高T区控制率。然而,反应是异质性的,治疗期间克隆源性肿瘤细胞的加速再增殖可能是决定这种反应的因素之一。本研究的目的是确定在缩短OTT时表皮生长因子受体(EGFr)和E-钙黏蛋白对T区控制的影响,以及这些标志物在选择加速放疗患者时是否能为组织病理学分级提供额外信息。共有209例来自DAHANCA随机试验的声门上喉鳞状细胞癌患者接受了不同OTT(9.5周、6.5周和5.5周)的原发性放疗。对可用的福尔马林固定石蜡包埋肿瘤组织重新评估组织病理学特征,并进行EGFr和E-钙黏蛋白染色。数据与患者和肿瘤特征以及5年T区控制情况相关。EGFr和E-钙黏蛋白与患者或肿瘤特征无关,除非EGFr与组织病理学特征为良好至中等的癌相关。高EGFr或低E-钙黏蛋白的肿瘤确实从缩短的OTT中获益,与具有其他EGFr和E-钙黏蛋白表达组合的肿瘤相比,两者(高EGFr和低E-钙黏蛋白)的治疗效果加速最为显著。当放疗总治疗时间缩短时,高表达EGFr和低表达E-钙黏蛋白的肿瘤T区控制增加最为显著,这些标志物可能有助于选择将从加速放疗中获益的患者。