Małecki Krzysztof, Gliński Bogdan, Mucha-Małecka Anna, Ryś Janusz, Kruczak Anna, Roszkowski Krzysztof, Urbańska-Gąsiorowska Marta, Hetnał Marcin
Department of Radiation Oncology, Center of Oncology - Maria Skłodowska-Curie Memorial Institute, Kraków, Poland.
Department of Pathology, Center of Oncology - Maria Skłodowska-Curie Memorial Institute, Kraków, Poland.
Rep Pract Oncol Radiother. 2010 Aug 3;15(4):87-92. doi: 10.1016/j.rpor.2010.06.001. eCollection 2010.
The optimal management of advanced laryngeal and hypopharyngeal cancers (L&HC) must involve consideration of both survival and functional effect of the given treatment approach. Despite over two decades of investigations of several treatment options, including surgery, radiotherapy, chemotherapy or some combinations thereof, little consensus exists as to which treatment offers the best survival, together with functional speech and swallowing.
To determine predictive and prognostic value of p53, EGFr, Ki-67 in patients with advanced laryngeal and hypopharyngeal cancer, treated with larynx preservation intent.
Thirty-three patients received 2-3 cycles of induction chemotherapy (ICHT) consisting of cisplatin and fluoruracil and underwent subsequent radical radiotherapy. Immunohistochemical analyzes of p53, EGFr and Ki-67 were performed.
Response to ICHT was obtained in 24 patients (75%). Better response to ICHT was correlated only with EGFr expression (p = 0.04, RR = 1.91). The 5-year loco-regional control (LRC) and disease-specific survival (DSS) rates were 48% and 57%, respectively. The 5-year larynx preservation rate was 68% in responders to ICHT compared to 21% in non-responders (p = 0.02). It was also higher in patients without EGFr expression (but not significantly, p = 0.43).
Lack of EGFr expression is a favorable predictive factor for response to ICHT. Neither p53 nor Ki-67 have predictive and prognostic value in larynx preservation treatment.
晚期喉癌和下咽癌（L&HC）的最佳治疗方案必须兼顾特定治疗方法的生存率和功能效果。尽管对包括手术、放疗、化疗或其联合治疗在内的多种治疗方案进行了二十多年的研究，但对于哪种治疗能提供最佳生存率以及功能言语和吞咽功能，仍未达成共识。
确定p53、表皮生长因子受体（EGFr）、Ki-67在以保留喉功能为目的治疗的晚期喉癌和下咽癌患者中的预测和预后价值。
33例患者接受了由顺铂和氟尿嘧啶组成的2 - 3周期诱导化疗（ICHT），随后接受根治性放疗。对p53、EGFr和Ki-67进行免疫组化分析。
24例患者（75%）对ICHT有反应。对ICHT反应较好仅与EGFr表达相关（p = 0.04，相对风险率RR = 1.91）。5年局部区域控制（LRC）率和疾病特异性生存率（DSS）分别为48%和57%。ICHT反应者的5年喉保留率为68%，无反应者为21%（p = 0.02）。在无EGFr表达的患者中喉保留率也较高（但无显著差异，p = 0.43）。
缺乏EGFr表达是对ICHT反应的有利预测因素。p53和Ki-67在喉保留治疗中均无预测和预后价值。
