Molecular markers as prognostic factors for local recurrence and radioresistance in head and neck squamous cell carcinoma

Smith, Benjamin D.; Haffty, Bruce G.

doi:10.1002/(sici)1520-6823(1999)7:3<125::aid-roi1>3.0.co;2-w

Cited by 67 publications

(27 citation statements)

References 115 publications

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“…While this system is adequate in predicting group responses to treatment, there is significant variability between individual patients within any particular stage. Although there have been a number of laboratory studies on radioresistance in early laryngeal cancer, at present there are no predictive molecular markers in routine use (Smith and Haffty 1999;Yoo et al, 2000;Cho et al, 2004;Nix et al, 2004a, b).…”

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Bcl-2 expression predicts radiotherapy failure in laryngeal cancer

et al. 2005

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Early stage laryngeal cancer can be effectively cured by radiotherapy or conservative laryngeal surgery. In the UK, radiotherapy is the preferred first line treatment. However, up to 25% of patients with T2 tumours will demonstrate locally persistent or recurrent disease at the original site, requiring salvage surgery to achieve a definitive cure. Patients experiencing treatment failure have a relatively poor prognosis. A retrospective analysis was conducted consisting of 124 patients with early stage (T1 -T2, N0) laryngeal squamous cell carcinoma. In total, 62 patients who failed radiotherapy were matched for T stage, laryngeal subsite and smoking history to a group of 62 patients successfully cured by radiotherapy. Using immunohistochemistry the groups were compared for expression of apoptotic proteins: bcl-2, bcl-X L , bax, bak and survivin. Radioresistant laryngeal cancer was associated with bcl-2 (Po0.001) and bcl-X L (P ¼ 0.005) expression and loss of bax expression (P ¼ 0.012) in pretreatment biopsies. Bcl-2 has an accuracy of 71% in predicting radiotherapy outcome. The association between expression of bcl-2, bcl-X L and bax with radioresistant cancer suggests a potential mechanism by which cancer cells avoid the destructive effects of radiotherapy. Predicting radioresistance, using bcl-2, would allow the clinician to recommend conservative laryngeal surgery as an alternative first line treatment to radiotherapy.

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Bcl-2 expression predicts radiotherapy failure in laryngeal cancer

et al. 2005

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“…However, the molecular heterogeneity seen within individual diagnostic categories has meant that no potential marker identified thus far has proven to be a sufficiently strong indicator of treatment response or prognosis. 7,8 Disease staging is largely based on anatomic considerations gained from clinical examination and imaging techniques. Differences in treatment response and outcome of patients with stagematched tumors suggest that the current staging systems are limited in their ability to predict locoregional control and survival for head and neck cancer patients.…”

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Molecular classification of oral cancer by cDNA microarrays identifies overexpressed genes correlated with nodal metastasis

Warner

Reis

Jurišica

et al. 2004

Intl Journal of Cancer

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“…[1][2][3] These tumors often display features associated with an aggressive disease phenotype and intrinsic radioresistance, which could account for this high rate of local treatment failure. 4 Because there is an established dose-response relationship in these tumors, escalating the radiation dose may improve tumor control and treatment outcomes. This has previously been difficult to implement with conventional radiotherapy techniques because of the increased risk of radiation-induced toxicity.…”

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confidence: 99%