Potential doubling time in head and neck tumors treated by primary radiotherapy: Preliminary evidence for a prognostic significance in local control

Renzo Corvo, Walter Giaretti, Giuseppe Sanguineti, Elio Geido, Roberto Orecchia, Salvina Barra, Giovanni Margarino, Almalina Bacigalupo, Vito Vitale

Research output: Contribution to journalArticle

Abstract

Purpose: The aim of the study was to determine preliminarily whether cell kinetic parameters evaluated using in vivo infusion of bromodeoxyuridine (BrdUrd) and flow cytometry, play a role as prognostic factors of loco-regional control in squamous cell head and neck carcinoma treated with radiotherapy. Methods and Materials: Between April 1989 and December 1991, 42 patients with unresectable Stage II-IV squamous cell carcinoma of the oral cavity, pharynx or larynx were given an infusion of BrdUrd solution prior to primary tumor biopsy sampling at 4-6 hr later. The simultaneous labeling S-phase fraction (LI) and duration (Ts) as well as the estimated potential doubling time (Tpot) were measured using flow cytometric analysis of BrdUrd and DNA content. Twenty-six patients received standard radiotherapy (70 Gy/35 fractions/7 weeks) whereas 15 patients were treated with the concomitant boost technique (75 Gy/40 fractions/6 weeks). Results: A complete set of flow cytometric data was available for 31 patients. The median value of LI, Ts, and Tpot were 9%, 9 hr and 5 days, respectively. Univariate analysis among the patients treated homogeneously by standard radiotherapy, indicated that local control was affected by Tpot value (p = 0.02). When the same analysis was performed for the patients treated with either standard radiotherapy or concomitant boost regimen, we found a p = 0.04. Thus, patients with a tumor Tpot value ≤ 5 days had a significantly lower three-year local control than patients with Tpot > 5 days. Log-rank test univariate analysis showed, in addition, that nodal status was the strongest prognostic factor of local control (p = 0.005). Age, tumor stage, tumor site, performance status, grading, radiotherapy regimen, DNA ploidy and LI value were, instead, not significantly related to loco-regional control. Finally, when comparing the type of radiotherapy for tumors with Tpot ≤ 5 days, we found a trend toward a better local control after concomitant boost regimen, with respect to standard regimen (p = 0.06). Conclusion: The present preliminary results suggest that Tpot could play a role as additional prognostic factor influencing the disease outcome in head and neck carcinoma treated by radiotherapy.

Original languageEnglish
Pages (from-to)1165-1172
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Volume27
Issue number5
DOIs
Publication statusPublished - Dec 1 1993

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Keywords

  • Bromodeoxyuridine
  • Cell Kinetics
  • Flow-cytometry
  • Head and neck tumors
  • Potential doubling time

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

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