CLINICAL POTENTIAL--FLOW CYTOMETRY IN HEAD/NECK CANCER

大多数头颈部鳞状细胞癌患者 (SCCHN)出现不治之症或可能失败的疾病 常规疗法。此外，不可接受的功能性和美观性 许多用传统疗法治愈的患者会产生缺陷。 心理治疗。有效的细胞毒疗法有治愈患者的潜力 通过高级疾病(诱导试验)，减少不受欢迎的 常规治疗的后果(器官保存试验)和 防止常规治疗(辅助试验)后复发。 细胞毒疗法只有在微小疾病的情况下才显示出这种潜力 已经被根除了。临床试验因模式的巨大差异而受阻 诱导治疗或复发后的细胞毒性反应 在临床相似的患者中进行常规治疗 疾病的特征和数量。 试图预测个体患者的临床结果 临床或形态参数差异的基础尚未得到证实 成功。细胞DNA含量的流式细胞仪检测 复发和以前未治疗的患者，以及连续 接受细胞毒治疗的晚期患者的测量结果表明 患有DNA二倍体肿瘤或重要亚群的患者不会 实现肿瘤的显微根除。在接受手术的晚期患者中 将手术作为初始治疗，减少复发率和改善疾病 自由生存和绝对生存与DNA二倍体相关 肿瘤。肿瘤生长和生长方式的显著差异 DNA二倍体和异倍体肿瘤的间质界面可能解释了 手术后局部区域复发率的差异。DNA含量 在进入SCCHN的患者中连续测定参数 On Southwest肿瘤组诱导试验(SWOG-8855)，目前正在进行 在鼻咽组间试验(INT-0099)中确定，以及 已经在进入的部分患者中确定 组间可切除试验(INT-O034)。政府已作出承诺， 西南肿瘤组、放射治疗肿瘤组(RTOG)和 东方合作肿瘤学小组(ECOG)回顾分析 来自INT-0034的剩余患者样本并前瞻性地确定 目前的组间试验中的细胞DNA含量参数 晚期不能切除疾病(INT-0126)与喉保留术。这个 DNA倍体类型的测定可能有助于临床预测 临床试验中晚期SCCHN患者的结果和选择。

Most patients with squamous cell cell carcinomas of the head and neck (SCCHN) present with disease that is incurable or likely to fail conventional therapy. Furthermore, unacceptable functional and cosmetic deficits are produced in many patients that are cured with conventional therapy. Effective cytotoxic therapy has the potential to cure patients with advanced disease (induction trials), reduce the undesirable consequences of conventional therapy (organ preservation trials) and prevent recurrences following conventional therapy (adjuvant trials). Cytotoxic therapy has shown such potential only when microscopic disease is eradicated. Clinical trials are hampered by wide variations in patterns of cytotoxic responses following induction therapy or recurrences following conventional therapy in patients with similar clinical characteristics and amounts of disease. Attempts to predict the clinical outcome of individual patients on the basis of differences in clinical or morphological parameters have not been successful. The flow cytometric measurements of cellular DNA content in recurrent and previously untreated patients, as well as serial measurements in advanced patients undergoing cytotoxic therapy, indicate that patients with DNA diploid tumors or significant subpopulations do not achieve microscopic eradication of tumor. In advanced patients undergoing surgery as initial therapy, reduced recurrence rates and superior disease free survival and absolute survival are associated with DNA diploid tumors. Significant differences in the patterns of tumor growth and stromal interface for DNA diploid and aneuploid tumors may account for the differences in local-regional relapse rates following surgery. DNA content parameters have been serially determined in patients with SCCHN entered onto Southwest Oncology Group induction trials (SWOG-8855), are currently being determined in the Nasopharyngeal Intergroup Trial (INT-0099), and have been determined in a portion of the patients entered onto the Intergroup Resectable Trial (INT-O034). Commitments have been made by the Southwest Oncology Group, the Radiation Therapy Oncology Group (RTOG) and the Eastern Cooperative Oncology Group (ECOG) to retrospectively analyze the remaining patient specimens from INT-0034 and prospectively determine the cellular DNA content parameters in the current Intergroup trials for Advanced Unresectable Disease (INT-0126) and Laryngeal Preservation. The determination of DNA ploidy classes may aid in the prediction of clinical outcome and selection of patients with advanced SCCHN in clinical trials.