Imbalance between proliferation and apoptosis may be responsible for treatment failure after postoperative radiotherapy in squamous cell carcinoma of the oropharynx
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- 作者：Grabenbauer ; Gerhard G. ; Suckorada ; Olga ; Niedobitek ; Gerald ; Rö ; del ; Franz ; Iro ; Heiner ; et. al.
- 关键词：Head and neck tumors ; Surgery ; Radiotherapy ; Apoptosis ; Proliferation
- 刊名：Oral Oncology
- 出版年：2003
- 出版时间：July, 2003
- 年：2003
- 卷：39
- 期：5
- 页码：459-469
- 全文大小：414 K
文摘
To assess the prognostic value of apoptosis, proliferation and clinical factors in squamous cell carcinoma of the oropharynx after radical surgery and postoperative radiotherapy (RT). Between 1985 and 1995, a total of 82 patients with 84 tumors were entered onto the study. Forty-two primary tumors (50 % ) involved the tonsils, 23 (27 % ) the soft palate, and 19 (23 % ) the base of the tongue. Median age was 52 years (range, 36–73 years). The pT- and pN-categories (UICC 1997) were: T1 (24), T2 (36), T3 (18), T4 (6), N0 (31), N1 (12), N2 (38), NX (8). Histologically clear margins were achieved in all patients by initial surgery. Postoperative RT to the primary and regional lymphatics was given with 60 Gy in 6 weeks and single daily fractions of 2 Gy. The expression of the nuclear Ki-67 labeling index (LI) was investigated by immunostaining using the monoclonal antibody MIB 1 and apoptotic carcinoma cells were identified using the terminal deoxynucleotidyltransferase-(TdT)-mediated dUTP nick end labeling (TUNEL) technique. Median follow-up was 43 months (range, 14–132 months). Overall survival, disease-free survival, and locoregional tumor control rates were 59, 70 and 76 % at 5 years. Median values for apoptotic index and Ki-67 labeling were 1.6 % (range 0–4.7 % ), and 20 % (range, 0–79 % ), respectively. Apoptotic index ≤1.6 % had a profound negative impact when associated with higher proliferation rates (5-year disease-free survival: 26 % ) as compared to all other patients with a balance between apoptosis and proliferation (5-year disease-free survival: 66–86 % , P