Heterogeneous distribution of tumor blood supply affects the response to chemotherapy in patients with head and neck cancer
Heterogeneous distribution of tumor blood supply affects the response to chemotherapy in patients with head and neck cancer
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DOI：
10.1038/sj.mn.7300126
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发表时间：
2000-12-01
期刊：
影响因子：
2.4
通讯作者：
Galmarini, D
中科院分区：
文献类型：
--
作者：
Galmarini, FC;Galmarini, CM;Galmarini, D
目的：为了评估肿瘤血供的不均匀分布是否会影响头颈部cancer.Methods患者对化疗的反应：我们用动脉内顺铂-博莱霉素方案加热了25例III/IV期患者。在治疗之前，通过导管将蓝色染料直接注射到肿瘤中。染色良好的区域被认为是大量灌注的区域，而染色不良的区域被认为是灌注不良的区域。每个肿瘤的两个区域的活检前和治疗后的组织病理学反应进行了评价，以下分级：I，肿瘤消失; II，破坏一些肿瘤巢; III; no changes.Results：I级反应达到13/25（52%）的丰富灌注区对1/25（4%）的灌注不良的地区（p < 0.001）。此外，总体反应存在显著差异（p < 0.001）：21/25（84%）在灌注丰富的区域，7/25（28%）在灌注不良的区域;和III级反应（4/25，16% vs. 18/25，72%）。为了确定在每个肿瘤的大量灌注和灌注不良区域中获得的组织病理学反应之间的可能相关性，我们然后计算Kendall的tau-b统计，获得tau值为0.279（p = 0.145）。这些数据表明，化疗的组织病理学反应的丰富灌注和灌注不良的地区是独立的，在每个tumor.Conclusions：在特纳血液供应的分布异质性影响化疗的反应，通过影响肿瘤内交付的治疗抽搐剂。在给肿瘤施用有效剂量的抗癌药物后：大量灌注区域的细胞得到足够的药物来破坏它们，而在细胞融合差的区域的细胞暴露于较低的药物浓度，因此存活。这种现象可以部分解释治疗人类实体瘤的困难。
Objective: To evaluate if the heterogeneous distribution of tumor blood supply affects the response to chemotherapy in patients with head and neck cancer.Methods: We heated 25 stage III/IV patients with an intraarterial cisplatinum-bleomycin regimen. Prior to treatment, a blue dye was injected directly to tumors through the catheter. Well-stained areas were considered as profusely perfused areas whereas poorly stained areas were considered as poorly perfused areas. Biopsies of both areas of each tumor were taken prior to and after the treatment and the histopathological response was evaluated with the following grading: I, tumor disappearance; II, destruction of some tumor nests; III; no changes.Results: Grade I responses were attained in 13/25 (52%) of profusely perfused areas against 1/25 (4%) of poorly perfused areas (p < 0.001). Moreover, there were significant differences (p < 0.001) in the overall responses: 21/25 (84%) in the, profusely perfused areas versus 7/25 (28%) in the poorly perfused areas; and in grade III responses (4/25, 16% vs. 18/25, 72%). To determine a possible correlation between the histopathological responses obtained in profusely perfused and in poorly perfused areas of each tumor, we then calculated the Kendall's tau-b statistics, obtaining a tau value of 0.279 (p = 0.145). This data indicated that histopathological responses to chemotherapy of profusely perfused and poorly perfused areas were independent in each tumor.Conclusions: Heterogeneity in the distribution of turner blood supply affects the response to chemotherapy by influencing the intratumoral delivery of therapeutic tic agents. After the administration of effective doses of anticancer drugs to a tumor: cells in profusely perfused areas receive enough to destroy them while cells in the poorly pel fused areas are exposed to lower drug concentrations and, therefore, survive. This phenomenon could explain in part the difficulty in the treatment of human solid tumors.