IN-VITRO PARAMETERS AND TREATMENT OUTCOME IN HEAD AND NECK CANCERS TREATED WITH SURGERY AND/OR RADIATION - CELL CHARACTERIZATION AND CORRELATIONS WITH LOCAL-CONTROL AND OVERALL SURVIVAL
IN-VITRO PARAMETERS AND TREATMENT OUTCOME IN HEAD AND NECK CANCERS TREATED WITH SURGERY AND/OR RADIATION - CELL CHARACTERIZATION AND CORRELATIONS WITH LOCAL-CONTROL AND OVERALL SURVIVAL
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DOI：
10.1016/0360-3016(94)90350-6
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发表时间：
1994-11-15
影响因子：
7
通讯作者：
FERTIL, B
中科院分区：
文献类型：
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作者：
GIRINSKY, T;BERNHEIM, A;FERTIL, B
目的：为了确定是否在体外参数（存活分数在2戈伊，α值，并计算细胞生长分数）是预测的治疗outcome.Methods和材料：活检获得的头部和颈部肿瘤的患者。使用CAM速率测定法测定体外参数。通过细胞遗传学分析对19种不同的细胞培养物进行细胞表征。在25个额外的细胞培养，细胞克隆形成进行了测试，使用库尔特奈米尔斯assay.Results：活检获得了156例头颈部肿瘤和口咽部是主要的原发部位。在113例（72%）中获得了体外参数（93例为SF 2，103例为计算的细胞生长分数）。细胞鉴定显示CAM平板中的细胞为二倍体，无克隆染色体异常，在软琼脂中产生集落，平均克隆效率为1.610（-3）。只有接受手术和/或放疗的患者（76）才有资格参加体外参数和治疗结局相关性研究。平均随访时间超过2年（范围9-47个月）。α值高于0.07戈伊（-1）临界点的患者的局部控制率显著较高（p = 0.04）（2年时为69% vs. 38%）。对于计算的细胞生长分数值高于临界点0.06%的患者，局部控制率也显著更高（p = 0.04）（第2年为70% vs. 48%）。此外，对于后者患者，总生存率也显著更高（p = 0.004）（2年时54% vs. 26%）。值得注意的是，低于临界点的α和计算的细胞生长分数值确定了一小群患者（约20%），他们的局部失败风险显著较高。从实用的角度来看，由于技术原因，在一定数量的实验中只能获得放射敏感性或计算的细胞生长分数值，因此分析了α和/或计算的细胞生长分数值低于临界水平的患者（约占所有患者的30%）的治疗结果。这组患者的情况明显更糟（p = 0.02）局部控制（2年时50% vs. 68%），（p = 0.04）总生存期（2年时为36% vs. 50%）。这些结果表明，使用CAM平板测定的体外参数，可能有助于预测头颈部肿瘤患者接受手术和术后放疗或单纯放疗的治疗结果。但是，必须将其视为初步结果，因为研究中使用的临界值是出于探索性目的而选择的。只有包括所有临床和生物学因素的多变量分析才能让我们得出任何确切的结论。
Purpose: To determine whether in vitro parameters (surviving fraction at 2 Gy, alpha values, and calculated cell growth fraction) were predictive of the treatment outcome.Methods and Materials: Biopsies were obtained from patients with a head and neck tumor. In vitro parameters were determined using the CAM prate assay. Cell characterization by cytogenetic analysis was performed on 19 different cell cultures. In 25 additional cell cultures, cell clonogenicity was tested using the Courtenay Mills assay.Results: Biopsies were obtained from 156 patients with a head and neck tumor and the oropharynx was the predominant primary site. In vitro parameters were obtained in 113 cases (72%) (SF2 in 93 cases and calculated cell growth fraction in 103 cases). Cell characterization showed that cells in CAM plates were diploid with no clonal chromosome abnormalities and gave colonies in soft agar with a mean cloning efficiency of 1.610(-3). Only patients treated with surgery and/or radiation (76), were considered eligible for in vitro parameters and treatment outcome correlation studies. The mean follow-up is over 2 years (range 9-47 months). The local control rate was significantly higher (p = 0.04) for patients with alpha values above the cut-off point of 0.07 Gy(-1) (69% vs. 38% at 2 years). The local control rate was also significantly higher (p = 0.04) for patients with calculated cell growth fraction values above the cut-off point of 0.06% (70% vs. 48% at 2 years). Moreover for these latter patients the overall survival rate was also significantly higher (p = 0.004) (54% vs. 26% at 2 years). It is worth noting that alpha and calculated cell growth fraction values below the cut-off points identified a small group of patients (about 20%) who were at a significantly high risk of local failure. From a pragmatic point of view, as only radiosensitivity or calculated cell growth fraction values could be obtained in a certain number of experiments due to technical reasons, the treatment outcome of patients who had either alpha and/ or calculated cell growth fraction values below the cutoff levels (about 30% of all patients) was analyzed. This group of patients fared significantly worse (p = 0.02) in terms of local control (50% vs. 68% at 2 years) and (p = 0.04) overall survival (36% vs. 50% at 2 years).Conclusion: These results suggest that in vitro parameters using the CAM plate assay, might be useful in predicting the treatment outcome of patients with a head and neck tumor treated with surgery and postoperative radiation, or radiation alone. However, they must be considered as preliminary because the cut offs used in the study were chosen for exploratory purposes. Only a multivariate analysis including all clinical and biologic factors mill allow us to draw any firm conclusions.