The prognostic value of epidermal growth factor receptor is related to tumor differentiation and the overall treatment time of radiotherapy in squamous cell carcinomas of the head and neck
The prognostic value of epidermal growth factor receptor is related to tumor differentiation and the overall treatment time of radiotherapy in squamous cell carcinomas of the head and neck
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DOI：
10.1016/j.ijrobp.2003.09.043
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发表时间：
2004-02-01
影响因子：
7
通讯作者：
Overgaard, J
中科院分区：
文献类型：
--
作者：
Eriksen, JG;Steiniche, T;Overgaard, J
目的：头颈部癌细胞增殖的加速可能与表皮生长因子受体（EGFr）等增殖因子的表达有关。本研究的重点是EGFr的T-网站控制的预后价值和肿瘤细胞分化和整体treatment time.Methods和材料的关系：我们研究了336例患者治疗与初级放射治疗使用66-68戈伊，2戈伊每部分和整体治疗时间为9 1/2，6 1/2，或5 1/2周。治疗前活检组织进行EGFr染色。结果：35%的癌细胞EGFr染色面积小于50%。小T大小和分化良好的肿瘤与高度染色相关（分别为p = 0.001和p = 0.002）。对于接受9 1/2周分疗程治疗的患者，EGFr对局部控制的预后影响较差，而对于接受5 1/2周加速治疗的患者，结果则相反。之前已经显示了结局、总体治疗时间和分化之间的类似关系。通过将低EGFr和/或低分化的肿瘤与高/中分化和高EGFr的肿瘤分开，一起分析这两个参数，导致T部位失败的比值比为12（1.43-104），0.91（0.51-1.65）和0.43（0.17-1.08），治疗时间分别为9 1/2、6 1/2和5 1/2周。肿瘤对分级变化的反应是不均匀的，EGFr和分化程度对预后的影响可能是相对的，并依赖于放疗的总治疗时间。(C)2004年爱思唯尔公司
Purpose: Accelerated repopulation in head-and-neck carcinomas might be related to the expression of proliferative factors such as epidermal growth factor receptor (EGFr). The present study focuses on the prognostic value of EGFr for T-site control and the relation to tumor cell differentiation and overall treatment time.Methods and Materials: We studied 336 patients treated with primary radiotherapy using 66-68 Gy, 2 Gy per fraction and overall treatment times of 9 1/2, 6 1/2, or 5 1/2 weeks. Pretreatment biopsies were stained for EGFr.Results: Thirty-five percent of the carcinomas had less than 50% of the area stained for EGFr. Small T-size and well-differentiated tumors was associated with a high degree of staining (p = 0.001 and p = 0.002, respectively). EGFr was of poor prognostic influence regarding local control in patients treated with 9 1/2 weeks split-course, whereas the opposite was found for patients given accelerated treatment in 5 1/2 weeks. A similar relationship between outcome, overall treatment time, and differentiation has previously been shown. The two parameters were analyzed together by separating the tumors with low EGFr and/or poor differentiation from tumors with well/moderate differentiation and high EGFr, resulting in odds ratios for T-site failure of 12 (1.43-104), 0.91 (0.51-1.65), and 0.43 (0.17-1.08), for treatment times of 9 1/2, 6 1/2, and 5 1/2 weeks, respectively.Conclusion: The tumor response to variations in fractionation is heterogeneous, and the prognostic impact of EGFr and-differentiation might be relative and dependent on the overall treatment time of radiotherapy. (C) 2004 Elsevier Inc.