Pretreatment oxygenation predicts radiation response in advanced squamous cell carcinoma of the head and neck
Pretreatment oxygenation predicts radiation response in advanced squamous cell carcinoma of the head and neck
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DOI：
10.1016/s0167-8140(96)01811-7
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发表时间：
1996-10-01
影响因子：
5.7
通讯作者：
Overgaard, J
中科院分区：
文献类型：
--
作者：
Nordsmark, M;Overgaard, M;Overgaard, J
背景与目的：低剂量放射治疗肿瘤细胞具有相对的放射抗性。这项研究的目的是在先进的鳞状细胞癌的头颈部和patients：治疗前的氧合状态和放射反应的相关性，测定在34个淋巴结和一个原发肿瘤颈部使用氧电极。主要氧合终点为pO（2）值小于2.5 mmHg的分数。患者接受标准化常规外放射治疗，剂量66-68戈伊，分33-34次。在这16例患者中，pO（2）值小于2.5 mmHg的分数中位数为22%（范围0-95%），而在局部肿瘤控制的患者中为6%（范围0-51%）。当通过pO（2）值小于2.5 mmHg的分数中位数将所有35例患者分开，并使用Kaplan-Meier估计值比较2年精算肿瘤控制概率时。缺氧程度最高的亚组具有显著较低的局部区域肿瘤控制（P=0.013，Logrank rest）。通过单变量回归分析，发现pO（2）值小于2.5 mmHg的分数作为连续变量具有显著性（P=0.010）。最后，通过考克斯多元回归分析发现，当使用pO（2）评估部位的肿瘤控制作为治疗终点时，pO（2）值小于2.5 mmHg的分数是预测放射反应的最强自变量（P=0.018）。这些结果表明，治疗前肿瘤氧合状态可预测放射反应，当使用pO（2）值小于2.5 mmHg的分数作为终点时。
Background and purpose: Hypoxic tumor cells are known to be relatively radioresistant. The aim of the study was to correlate oxygenation status and radiation response in advanced squamous cell carcinomas of head and neck.Methods and patients: Pretreatment oxygenation status was measured in 34 lymph nodes and one primary tumor neck using oxygen electrodes. The primary oxygenation endpoint was the fraction of pO(2) values less than 2.5 mmHg. Patients received standardized, conventional, external radiotherapy 66-68 Gy in 33-34 fractions.Results: Sixteen patients had loco-regional failure. Among these 16 patients the median of the fraction of pO(2) values less than 2.5 mmHg was 22% (range 0-95%) as compared to 6% (range 0-51%) among patients with loco-regional tumor control. When separating all 35 patients by the median of the fraction of pO(2) values less than 2.5 mmHg and comparing the 2 years actuarial tumor control probability using Kaplan-Meier estimates. the most hypoxic subgroup had significantly lower loco-regional tumor control(P=0.013, Logrank rest). By univariate regression analysis the fraction of pO(2) values less than 2.5 mmHg was found to be significant as continuous variable (P=0.010). Finally, by Cox multiple regression analysis the fraction of pO(2) values less than 2.5 mmHg was found to be the strongest independent variable in predicting radiation response when using tumor control in the site of pO(2) assessment as treatment endpoint (P=0.018).Conclusion: These results suggest that pretreatment tumor oxygenation status is predictive of radiation response, when using the fraction of pO(2) values less than 2.5 mmHg as endpoint.