INTRATUMORAL PO2 PREDICTS SURVIVAL IN ADVANCED CANCER OF THE UTERINE CERVIX
INTRATUMORAL PO2 PREDICTS SURVIVAL IN ADVANCED CANCER OF THE UTERINE CERVIX
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DOI：
10.1016/0167-8140(93)90025-4
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发表时间：
1993-01-01
影响因子：
5.7
通讯作者：
VAUPEL, P
中科院分区：
文献类型：
--
作者：
HOCKEL, M;KNOOP, C;VAUPEL, P
实验证据表明，实体瘤中的缺氧部分可能会增加其恶性潜力，并降低其对非手术治疗方式（例如标准照射，某些抗癌药物）的敏感性。然而，肿瘤缺氧的临床重要性仍然不确定，因为有效的方法进行常规测量肿瘤内的O2-张力的患者迄今为止一直缺乏。一个临床上适用的标准化程序已经建立，使肿瘤内的氧张力在晚期宫颈癌的测定，通过使用计算机极谱针电极组织学系统。通过这种方法测量的肿瘤氧合代表了一种新的肿瘤特征，其可以针对每个肿瘤单独确定，并且独立于其他已知的肿瘤学参数。本文介绍了一项开放性前瞻性临床试验的中期分析结果，该试验根据前31例患者的生存数据评价肿瘤氧合的预后意义。15例患者接受了一次放疗，11例患者接受了包括放疗在内的综合治疗。中位随访19个月（范围5-31个月）后，Kaplan-Meier寿命表分析显示，与氧合较好的肿瘤患者（中位pO 2> 10 mmHg）相比，中位pO 2小于或等于10 mmHg的患者的生存率和无复发生存率显著降低。考克斯比例风险模型显示，根据FIGO的中位pO 2和临床分期是生存期和无复发生存期的独立、高度显著的预测因子。我们从这些初步结果得出结论，肿瘤氧合作用这个标准化的程序确定似乎是一个新的独立的预后因素，影响生存晚期宫颈癌。
Experimental evidence suggests that the hypoxic fraction in a solid tumor may increase its malignant potential and reduce its sensitivity towards non-surgical treatment modalities (e.g. standard irradiation, certain anticancer agents). However, the clinical importance of tumor hypoxia remains uncertain since valid methods for the routine measurement of intratumoral O2-tensions in patients have so far been lacking. A clinically applicable standardized procedure has been established which enables the determination of intratumoral oxygen tensions in advanced cervical cancers by use of a computerized polarographic needle electrode histography system. Tumor oxygenation as measured by this method represents a novel tumor feature which can be individually determined for each tumor and which is independent from other known oncological parameters. The results of an interim analysis of an open prospective clinical trial to evaluate the prognostic significance of tumor oxygenation based on the survival data of the first 31 patients are presented. Fifteen patients have been treated by primary radiation, 11 patients received multimodality therapy including irradiation. After a median follow-up of 19 months (range 5-31 months), Kaplan-Meier-life table analysis showed significantly lower survival and recurrence-free survival for patients with a median pO2 of less-than-or-equal-to 10 mmHg compared to those with better oxygenated tumors (median pO2> 10 mmHg). The Cox proportional hazards model revealed that the median pO2 and the clinical stage according to the FIGO are independent, highly significant predictors of survival and recurrence-free survival. We conclude from these preliminary results that tumor oxygenation as determined with this standardized procedure appears to be a new independent prognostic factor influencing survival in advanced cancer of the uterine cervix.