CLINICAL POTENTIAL--FLOW CYTOMETRY IN HEAD/NECK CANCER

大多数头颈部鳞状细胞癌患者 （SCCHN）存在无法治愈或可能失败的疾病 常规治疗。此外，不可接受的功能和外观 在许多患者中产生缺陷，这些患者用常规的 疗法 有效的细胞毒疗法有可能治愈患者 对于晚期疾病（诱导试验）， 常规治疗的后果（器官保存试验）和 预防常规治疗后复发（辅助试验）。 细胞毒性治疗只有在显微镜下的疾病 被根除了临床试验因模式的广泛差异而受到阻碍 诱导治疗或复发后的细胞毒性反应 在具有相似临床症状的患者中进行常规治疗后， 疾病的特征和数量。 试图预测个体患者的临床结果， 临床或形态学参数差异的基础尚未确定， 成功流式细胞术检测人乳腺癌细胞DNA含量 复发和既往未治疗的患者，以及连续 接受细胞毒性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 实现肿瘤的显微根除。在晚期患者中， 手术作为初始治疗，降低复发率和上级疾病 自由存活率和绝对存活率与DNA二倍体有关 肿瘤的肿瘤生长模式的显著差异， DNA二倍体和非整倍体肿瘤的基质界面可能解释了 手术后局部区域复发率的差异。DNA含量 已连续测定入选SCCHN患者的参数， 西南肿瘤组诱导试验（SWOG-8855），目前 在鼻咽组间试验（INT-0099）中确定，和 已在一部分患者中确定， 组间可切除试验（INT-O 034）。 已作出承诺， 西南肿瘤学组，放射治疗肿瘤学组（RTOG）和 东部肿瘤协作组（ECOG）回顾性分析 INT-0034的剩余患者标本，并前瞻性确定 当前组间试验中的细胞DNA含量参数 晚期不可切除疾病（INT-0126）和喉保留。的 DNA倍体类型的测定可能有助于预测临床 临床试验中晚期SCCHN患者的结局和选择。

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.