CLINICAL APPLICATIONS-FLOW CYTOMETRY IN HEAD AND NECK CA

晚期、不能切除的头颈部鳞状细胞癌 (H&N)仍然是一种不治之症，尽管进行了积极的手术和/或 放射疗法。增加了单一化疗和联合化疗 手术和/或放射治疗，试图改善这一结果。 在含有顺铂的情况下，细胞减少的效果非常显著 总有效率在80%至90%并完成的方案 已报告的应答率在50-60%的范围内。在最后一次 六年来，已有300多名此类患者接受了这些方案的治疗 韦恩州立大学。在这些试验中，有有利的也有不利的 预后分组是在临床的基础上确定的 临床表现和对化疗的初步反应。仔细审查这些内容 试验未能确定临床或形态标准 在治疗前识别或预测这些具有预后意义的重要因素 以个别病人为基础进行分组。最近，蜂窝参数 通过流式细胞术(FCM)测定，特别是细胞DNA含量为 由DNA指数(DI)和S相比例(SPF)定义，已被 据报道与化疗反应、存活率和 大型异质性肿瘤组的生物学行为以及 某些个体肿瘤。此应用程序建议调查 确定治疗上和预后上重要的可能性 用流式细胞仪测定H&N SCC亚群的细胞参数。是这样的 识别将允许对临床进行适当的分层 试验，为预后较差的群体设计更积极的方案 以及识别和研究生物差异的能力 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.