Strahlenther Onkol. 2013 Oct;189(10):849-55. doi: 10.1007/s00066-013-0389-z.
This study investigated the prognostic value of androgen receptor (AR) expression of tumor cells in patients treated with surgery and subsequent radio(chemo)therapy for locally advanced squamous cell carcinoma of the head and neck (SCCHN).
The impact of AR and 11 additional factors on locoregional control (LRC), metastases-free survival (MFS), and overall survival (OS) was retrospectively studied in 163 patients with nonmetastatic stage III/IV SCCHN. Additional factors included age, gender, ECOG performance status, pre-radiotherapy (pre-RT) hemoglobin levels, tumor site, histologic grade, T category, N category, HPV status, extent of resection, and concurrent chemotherapy.
On multivariate analysis, improved LRC was significantly associated with pre-RT hemoglobin levels≥12 g/dl (risk ratio [RR] 2.22; 95% confidence interval [CI] 1.19–4.13; p=0.013), tumor site (RR 1.39; 95% CI 1.14–1.70; p=0.001), lower T category (RR 1.67; 95% CI 1.18–2.44; p=0.003), and lower N category (RR 4.18; 95% CI 1.90–10.55; p<0.001). Improved MFS was associated with AR expression (RR 2.21; 95% CI 1.01–5.41; p=0.048), better ECOG performance status (RR 3.19; 95% CI 1.50–7.14; p=0.003), lower T category (RR 2.24; 95% CI 1.47–3.65; p<0.001), and lower N category (RR 5.33; 95% CI 2.07–16.63; p<0.001). OS was positively associated with AR expression (RR 1.99; 95% CI 1.06–4.00; p=0.032), better ECOG performance status (RR 2.20; 95% CI 1.20–4.09; p=0.010), pre-RT hemoglobin levels≥12 g/dl (RR 2.13; 95% CI 1.19–3.82; p=0.012), lower T category (RR 1.81; 95% CI 1.30–2.62; p<0.001), and lower N category (RR 3.41; 95% CI: 1.65–7.80; p<0.001).
Tumor cell expression of AR was an independent prognostic factor for MFS and OS and should be considered in future prospective trials.
本研究旨在探讨雄激素受体（AR）在接受手术和随后放化疗的局部晚期头颈部鳞状细胞癌（SCCHN）患者中的肿瘤细胞表达的预后价值。
回顾性分析了 163 例非转移性 III/IV 期 SCCHN 患者的 AR 和 11 个额外因素对局部区域控制（LRC）、无转移生存（MFS）和总生存（OS）的影响。其他因素包括年龄、性别、ECOG 表现状态、放疗前（pre-RT）血红蛋白水平、肿瘤部位、组织学分级、T 分类、N 分类、HPV 状态、切除范围和同期化疗。
多因素分析显示，LRC 改善与 pre-RT 血红蛋白水平≥12 g/dl（风险比[RR]2.22；95%置信区间[CI]1.19-4.13；p=0.013）、肿瘤部位（RR1.39；95%CI1.14-1.70；p=0.001）、较低的 T 分类（RR1.67；95%CI1.18-2.44；p=0.003）和较低的 N 分类（RR4.18；95%CI1.90-10.55；p<0.001）显著相关。MFS 改善与 AR 表达（RR2.21；95%CI1.01-5.41；p=0.048）、更好的 ECOG 表现状态（RR3.19；95%CI1.50-7.14；p=0.003）、较低的 T 分类（RR2.24；95%CI1.47-3.65；p<0.001）和较低的 N 分类（RR5.33；95%CI2.07-16.63；p<0.001）相关。OS 与 AR 表达（RR1.99；95%CI1.06-4.00；p=0.032）、更好的 ECOG 表现状态（RR2.20；95%CI1.20-4.09；p=0.010）、pre-RT 血红蛋白水平≥12 g/dl（RR2.13；95%CI1.19-3.82；p=0.012）、较低的 T 分类（RR1.81；95%CI1.30-2.62；p<0.001）和较低的 N 分类（RR3.41；95%CI：1.65-7.80；p<0.001）呈正相关。
肿瘤细胞 AR 表达是 MFS 和 OS 的独立预后因素，应在未来的前瞻性试验中加以考虑。
