Predilection of Clinical Response to Chemotherapy in Head and Neck Cancer -Correlation of Apoptosis related genes and Chemosensitivity-

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1. A study of an anticancer drug sensitivity test suing the SDI test : The succinate dehydrogenase inhibition (SDI) test was carried out for 55 head and neck cancers. As a results, the evaluable rate of the SDI test was 80%. Cancer cells from the involved lumph nodes showed a tendency to low calculated inhibition rate (i. R.) as compared with those from primary tumors. The in vitro results were compared with the clinical responses of the recurrent patients who were treated by CDDP/5FU.Predictive accuracies of CDDP and 5FU were 56%and 63%, respectively.2. A study of an anticancer drug sensitivity test using the HSRA test : Histoculture drug response assay (HDRA) with MTT-endpoint was performed for 40 head and neck cancers. using a concentration-I.R.curve and a concentration-efficacy rate curve, the optimal cutoff concentration was estimated as 20mug/ml for CDDP,300mug/ml for 5FU and15mug/ for adriamycin. I.R.at CDDP 20mug/ml from the involved lumph nodes showed a significantly lower value than that of primary tumors of squamous cell carcinoma. The in vitro results at CDDP 20mug/ml were compared with the clinical responses of 13 patients who were treated by VDDP/5FU.Significant correlation between in vitro and in vivo results was observed. The predictive accuracy for response to chamotherapy was 77%.3. Immunohistochamical study : The correlation betwen an anticancer sensitibity test and the status of p53, bcl-2, Glutathione S-Transferase pi and Metallothionein (MT) using immunohistochemical staining was examined. Positive staining of p53 and MT significantly correlated with lower I.R.at CDDP 20mug/ml of HDRA assay. Their predictive accuracy for response to chemotherapy was 75% and 50%, respectively.4. Results : HDRA assay and the status of p53 using immonuhistochamical staining are extremely useful in the prediction of response to chamotheray for head and neck cancer.