CLINICAL APPLICATIONS/FLOW CYTOMETRY IN HEAD/NECK CANCER

晚期、不可切除的头颈部鳞状细胞癌（SCC） （H&N）仍然是一种不治之症，尽管积极的外科手术和/或 放射治疗 单药和联合化疗已被添加到 手术和/或放射治疗以试图改善这种结果。 使用含顺铂的药物已经实现了令人印象深刻的细胞减少。 总体缓解率在80%至90%之间的方案， 据报告，答复率在50-60%之间。 在过去 六年来，300多名这样的患者接受了这些方案的治疗， 韦恩州立大学。 在这些试验中，有利的和不利的 预后组已确定的基础上，临床 表现和对化疗的初始反应。 仔细查看这些 试验未能确定临床或形态学标准， 治疗前认识或预测这些重要的 以个体患者为基础的亚组。 最近，细胞参数 通过流式细胞术（FCM）测定，特别是细胞DNA含量， 由DNA指数（DI）和S期百分比（SPF）定义， 据报道，与化疗反应、生存率和 大的异质性肿瘤组中的生物学行为以及 个别肿瘤。 本申请建议调查 确定治疗和药理学重要性的可能性 用流式细胞仪测定H&N SCC的细胞参数。 等 识别将允许适当的临床分层 试验，为预后不良组设计更积极的方案 以及识别和研究生物学差异的能力 这些临床亚组。

Advanced, unresectable squamous cell cancer (SCC) of the Head and Neck (H&N) remains an incurable disease in spite of aggressive surgical and/or radiation therapy. Single and combination chemotherapy has been added to surgery and/or radiation therapy in an attempt to improve this outcome. Impressive cytoreduction has been achieved with cis-platinum containing regimens with overall response rates between 80 and 90% and complete response rates in the range of 50-60% having been reported. In the last six years over 300 such patients have been treated with these regimens at Wayne State University. During these trials both favorable and unfavorable prognostic groups have been identified on the basis of clinical presentation and initial response to chemotherapy. Careful review of these trials has failed to identify clinical or morphological criteria that pretherapeutically recognize or predict these prognostically important subgroups on an individual patient basis. Recently, cellular parameters determined by flow cytometry (FCM) particularly cellular DNA content as defined by DNA index (DI) and percent S phase fraction (SPF), have been reported to correlate with response to chemotherapy, survival and biological behavior in large heterogenous groups of tumors as well as certain individual tumors. This application proposes to investigate the possibility of identifying therapeutically and prognostically important subgroups of SCC of H&N using FCM determined cellular parameters. Such identification would allow the appropriate stratification of clinical trials, the design of more aggressive protocols for poor prognostic groups and the ability to recognize and study the biological differences between these clinical subgroups.