Hoogsteen Ilse J, Marres Henri A M, Bussink Johan, van der Kogel Albert J, Kaanders Johannes H A M
Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, The Netherlands.
Head Neck. 2007 Jun;29(6):591-604. doi: 10.1002/hed.20543.
Hypoxia and tumor cell proliferation are important factors determining the treatment response of squamous cell carcinomas of the head and neck. Successful approaches have been developed to counteract these resistance mechanisms although usually at the cost of increased short- and long-term side effects. To provide the best attainable quality of life for individual patients and the head and neck cancer patient population as a whole, it is of increasing importance that tools be developed that allow a better selection of patients for these intensified treatments.
A literature review was performed with special focus on the predictive value and clinical relevance of endogenous hypoxia-related markers.
New methods for qualitative and quantitative assessment of functional microenvironmental parameters such as hypoxia, proliferation, and vasculature have identified several candidate markers for future use in predictive assays. Hypoxia-related markers include hypoxia inducible factor (HIF)-1alpha, carbonic anhydrase IX, glucose transporters, erythropoietin receptor, osteopontin, and others. Although several of these markers and combinations of markers are associated with treatment outcome, their clinical value as predictive factors remains to be established.
A number of markers and marker profiles have emerged that may have potential as a predictive assay. Validation of these candidate assays requires testing in prospective trials comparing standard treatment against experimental treatments targeting the related microregional constituent.
缺氧和肿瘤细胞增殖是决定头颈部鳞状细胞癌治疗反应的重要因素。虽然已经开发出成功的方法来对抗这些耐药机制，但通常是以增加短期和长期副作用为代价。为了为个体患者以及整个头颈部癌症患者群体提供最佳的生活质量，开发能够更好地选择适合这些强化治疗的患者的工具变得越来越重要。
进行了一项文献综述，特别关注内源性缺氧相关标志物的预测价值和临床相关性。
用于定性和定量评估功能微环境参数（如缺氧、增殖和血管生成）的新方法已经确定了几种未来可用于预测分析的候选标志物。缺氧相关标志物包括缺氧诱导因子（HIF）-1α、碳酸酐酶IX、葡萄糖转运蛋白、促红细胞生成素受体、骨桥蛋白等。虽然这些标志物中的几种以及标志物组合与治疗结果相关，但其作为预测因子的临床价值仍有待确定。
已经出现了一些可能具有预测分析潜力的标志物和标志物谱。这些候选分析方法的验证需要在前瞻性试验中进行测试，将标准治疗与针对相关微区域成分的实验性治疗进行比较。
