Department of Radiation Oncology, National Cancer Center Hospital, Japan.
Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Japan.
J Radiat Res. 2020 Jan 23;61(1):161-168. doi: 10.1093/jrr/rrz071.
Our previous study by Murakami N, Mori T, Nakamura S, Yoshimoto S, Honma Y, Ueno T, Kobayashi K, Kashihara T, Takahashi K, Inaba K, Okuma K, Igaki H, Nakayama Y, Itami J. (J Radiat Res. 2019 Jul 30. pii: rrz053. doi: 10.1093/jrr/rrz053. [Epub ahead of print]) showed that strong expression of epithelial cell adhesion molecule (EpCAM) was associated with radiation resistance in head and neck squamous cell cancer patients (SCC). In this study, the prognostic impact of histopathologic features including EpCAM for nasopharyngeal cancer (NPC) patients was investigated. Since 2009, our institution has performed chemoradiation for locally advanced NPC patients with intensity modulated radiation therapy (IMRT). Tri-weekly adjuvant cisplatin (CDDP, 80 mg/m2) was administered concurrently with definitive radiation therapy 70 Gy in 35 fractions. One month after radiation therapy, adjuvant chemotherapy of three cycles of CDDP/5 fluorouracil (5-FU) was administered. Using a pretreatment biopsy specimen, EBV-encoded small RNA in situ hybridization (EBER-ISH), EpCAM, p16 and p53 were assessed by immunohistochemical analysis. Between May 2009 and September 2017, 51 NPC patients received definitive radiation therapy. Five, 13, 17 and 16 patients were staged as I, II, III and IV, respectively. The median follow-up period for alive patients was 31.1 months (12.4-109.7 months). Three-year overall survival (OS), progression-free survival (PFS) and locoregional control (LRC) were 87.1, 57.1 and 85.7%, respectively. EpCAM, p16 and p53 were not associated with PFS, OS nor LRC. Three-year PFS for patients with keratinizing and non-keratinizing SCC were 25 and 60.5%, respectively (P = 0.033, hazard ratio 4.851 (95% confidence interval 1.321-17.814)).Prognosis of NPC patients with keratinizing SCC was worse than non-keratinizing SCC patients, suggesting a biological difference between the two types of tumor.
我们之前的研究表明，Murakami N、Mori T、Nakamura S、Yoshimoto S、Honma Y、Ueno T、Kobayashi K、Kashihara T、Takahashi K、Inaba K、Okuma K、Igaki H、Nakayama Y 和 Itami J（J Radiat Res. 2019 Jul 30. pii: rrz053. doi: 10.1093/jrr/rrz053. [Epub ahead of print]）发现上皮细胞黏附分子（EpCAM）的强表达与头颈部鳞状细胞癌患者的放射抵抗有关。在这项研究中，我们研究了包括 EpCAM 在内的组织病理学特征对鼻咽癌（NPC）患者的预后影响。自 2009 年以来，我们机构对局部晚期 NPC 患者进行了调强放疗（IMRT）的放化疗。每周三次辅助顺铂（CDDP，80mg/m2）与 70Gy 分 35 次的标准放疗同时进行。放疗后 1 个月，给予三个周期的 CDDP/5-氟尿嘧啶（5-FU）辅助化疗。使用预处理活检标本，通过免疫组织化学分析评估 EBV 编码的小 RNA 原位杂交（EBER-ISH）、EpCAM、p16 和 p53。2009 年 5 月至 2017 年 9 月，51 例 NPC 患者接受了根治性放疗。5、13、17 和 16 例患者分别分期为 I、II、III 和 IV 期。存活患者的中位随访时间为 31.1 个月（12.4-109.7 个月）。3 年总生存率（OS）、无进展生存率（PFS）和局部区域控制率（LRC）分别为 87.1%、57.1%和 85.7%。EpCAM、p16 和 p53 与 PFS、OS 或 LRC 无关。角化型和非角化型 SCC 患者的 3 年 PFS 分别为 25%和 60.5%（P=0.033，风险比 4.851（95%置信区间 1.321-17.814））。角化型 SCC NPC 患者的预后较非角化型 SCC 患者差，提示两种类型肿瘤存在生物学差异。
