Bourhis J, Dendale R, Hill C, Bosq J, Janot F, Attal P, Fortin A, Marandas P, Schwaab G, Wibault P, Malaise E P, Bobin S, Luboinski B, Eschwege F, Wilson G
Department of Radiotherapy, Institut Gustave Roussy Villejuif France.
Int J Radiat Oncol Biol Phys. 1996 Jun 1;35(3):471-6. doi: 10.1016/s0360-3016(96)80008-3.
To study the predictive value of pretreatment potential doubling time and labeling index, as measured by flow cytometry in patients with head and neck squamous cell carcinoma treated with conventional radiotherapy.
70 patients with a squamous cell carcinoma of the oropharynx and 4 patients with another involved head and neck site were entered in this prospective study. The duration of the S phase (TS), the labeling index (LI), and the potential doubling time (Tpot) were obtained by flow cytometry measurements of a tumor biopsy obtained after i.v. injection of 200 mg bromodeoxyuridine to the patient. The treatment consisted of 70 Gy in 7 weeks, 2 Gy per fraction and five fractions per week.
The mean and median LI were 7.7% (standard deviation, SD: 5.0) and 6.3%, respectively. The mean and median TS were 9.3 h (SD: 3.6) and 8.3 h, respectively. The mean and median Tpot were 5.6 days (SD: 5.4) and 4.6 days, respectively. No significant relationship was found between the Tpot or LI and the tumor stage (T), nodal status (N), histological grade, and the site of the primary within the oropharynx. The only parameter significantly associated with an increased risk of local relapse was the tumor stage (p < 0.001). The mean Tpot for the group of tumors that relapsed locally was 5.3 days (SD: 3.3), compared to 6.1 days (SD: 4.08) for those who did not relapse locally (NS). Two parameters were significantly associated with a decrease in disease-free (DFS) and overall survival, namely the tumor stage (p < 0.005, and p < 0.001, respectively, for DFS and overall survival) and nodal involvement (p = 0.02 and (p < 0.005, respectively, for DFS and overall survival). The TS, LI, DNA index, and Tpot were not significantly associated with local relapse, DFS, and survival, either in the univariate or in the multivariate analysis.
The method used to evaluate tumor cell kinetics did not provide clinically relevant kinetic parameters for this type of cancer. The classic prognostic factors (tumor stage and nodal status) were strongly associated with clinical outcome.
研究通过流式细胞术测量的预处理潜在倍增时间和标记指数在接受常规放疗的头颈部鳞状细胞癌患者中的预测价值。
70例口咽鳞状细胞癌患者和4例其他头颈部受累部位患者纳入了这项前瞻性研究。静脉注射200mg溴脱氧尿苷给患者后，通过对肿瘤活检组织进行流式细胞术测量，获得S期持续时间（TS）、标记指数（LI）和潜在倍增时间（Tpot）。治疗方案为7周内给予70Gy，每次2Gy，每周5次。
LI的均值和中位数分别为7.7%（标准差，SD：5.0）和6.3%。TS的均值和中位数分别为9.3小时（SD：3.6）和8.3小时。Tpot的均值和中位数分别为5.6天（SD：5.4）和4.6天。未发现Tpot或LI与肿瘤分期（T）、淋巴结状态（N）、组织学分级以及口咽内原发部位之间存在显著关系。与局部复发风险增加显著相关的唯一参数是肿瘤分期（p<0.001）。局部复发肿瘤组的平均Tpot为5.3天（SD：3.3），而未局部复发者为6.1天（SD：4.08）（无显著性差异）。有两个参数与无病生存期（DFS）和总生存期的降低显著相关，即肿瘤分期（DFS和总生存期分别为p<0.005和p<0.001）和淋巴结受累情况（DFS和总生存期分别为p = 0.02和p<0.005）。在单因素或多因素分析中，TS、LI、DNA指数和Tpot与局部复发、DFS和生存期均无显著相关性。
用于评估肿瘤细胞动力学的方法未为此类癌症提供临床相关的动力学参数。经典的预后因素（肿瘤分期和淋巴结状态）与临床结局密切相关。
