Apoptosis in carcinoma of the bladder:: Relation with radiation treatment results
Apoptosis in carcinoma of the bladder:: Relation with radiation treatment results
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DOI：
10.1016/s0360-3016(98)00472-6
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发表时间：
1999-03-15
影响因子：
7
通讯作者：
Santana, C
中科院分区：
文献类型：
--
作者：
Lara, PC;Pérez, S;Santana, C
目的：放射治疗广泛应用于膀胱癌的治疗。寻找能够选择对放射治疗有反应的患者的生物学参数已变得至关重要。本研究的目的是评估预处理凋亡指数是否可用于预测一组接受放射治疗的膀胱癌患者的局部控制和生存。1983 ~ 1996年共收治浸润性膀胱癌55例，放疗中位剂量66戈伊，平均63.28戈伊，每日剂量为1.8-2戈伊。在苏木精-伊红切片中研究凋亡细胞。结果：治疗前肿瘤细胞凋亡指数与肿瘤分期、核分裂指数、Ki 67增殖指数相关，与肿瘤局部控制和生存率相关。整个组的5年精确局部控制率为45%。与高凋亡肿瘤相比，低凋亡指数的肿瘤患者具有更好的局部控制率（p < 0.037）和生存率（p < 0.01）。多因素分析显示肿瘤分期（T2 vs.T3 -4）和治疗前凋亡指数是预测局部控制和生存率的重要因素。结论：治疗前凋亡指数可用于预测膀胱癌患者放射治疗的临床结局，评估肿瘤生物学特性可为患者选择不同的治疗策略提供依据。(C)1999 Elsevier Science Inc.
Purpose: Radiotherapy is widely used in the treatment of bladder cancer. The search for biological parameters that could select patients who will respond to radiation treatment has become essential, The aim of this study is to assess whether the pretreatment apoptotic index is useful in predicting local control and survival in a group of bladder cancer patients treated by radiotherapy.Methods and Materials: Fifty-five patients with invasive bladder carcinoma treated between 1983 and 1996 were included in this study, Radiotherapy was given to a median dose of 66 Gy, mean 63.28 Gy, in 1.8-2 Gy daily fractions. Apoptotic cells were studied in hematoxylin-eosin slides. Clinicopathological tumor characteristcs were studied in relation to the apoptotic index, and as prognostic factors for local control and survival in both univariate and multivariate analysis.Results: Pretreatment apoptotic indexes were related to tumor stage, mitotic index, and Ki67 proliferation index. Five-year actuarial local control for the whole group was 45%, Patients with tumors showing low pretreatment apoptotic indexes had better local control (p < 0.037) and survival (p < 0.01) than highly apoptotic tumors. Tumor stage (T2 vs. T3-4) and the pretreatment apoptotic index were significant predictive factors for local control and survival in multivariate analysis.Conclusions: The pretreatment apoptotic index is useful in predicting the clinical outcome of bladder cancer patients treated by radiotherapy, Assessment of biological tumor characteristics could allow the selection of patients for different treatment strategies. (C) 1999 Elsevier Science Inc.