title: Potential doubling time and clinical outcome in head and neck squamous cell carcinoma treated with 70 GY in 7 weeks.
abstract: OBJECTIVE
  To study the predictive value of pretreatment potential doubling time and labeling index, as measured by flow cytometry in patients with head and neck squamous cell carcinoma treated with conventional radiotherapy.
  
  
  METHODS
  70 patients with a squamous cell carcinoma of the oropharynx and 4 patients with another involved head and neck site were entered in this prospective study. The duration of the S phase (TS), the labeling index (LI), and the potential doubling time (Tpot) were obtained by flow cytometry measurements of a tumor biopsy obtained after i.v. injection of 200 mg bromodeoxyuridine to the patient. The treatment consisted of 70 Gy in 7 weeks, 2 Gy per fraction and five fractions per week.
  
  
  RESULTS
  The mean and median LI were 7.7% (standard deviation, SD: 5.0) and 6.3%, respectively. The mean and median TS were 9.3 h (SD: 3.6) and 8.3 h, respectively. The mean and median Tpot were 5.6 days (SD: 5.4) and 4.6 days, respectively. No significant relationship was found between the Tpot or LI and the tumor stage (T), nodal status (N), histological grade, and the site of the primary within the oropharynx. The only parameter significantly associated with an increased risk of local relapse was the tumor stage (p < 0.001). The mean Tpot for the group of tumors that relapsed locally was 5.3 days (SD: 3.3), compared to 6.1 days (SD: 4.08) for those who did not relapse locally (NS). Two parameters were significantly associated with a decrease in disease-free (DFS) and overall survival, namely the tumor stage (p < 0.005, and p < 0.001, respectively, for DFS and overall survival) and nodal involvement (p = 0.02 and (p < 0.005, respectively, for DFS and overall survival). The TS, LI, DNA index, and Tpot were not significantly associated with local relapse, DFS, and survival, either in the univariate or in the multivariate analysis.
  
  
  CONCLUSIONS
  The method used to evaluate tumor cell kinetics did not provide clinically relevant kinetic parameters for this type of cancer. The classic prognostic factors (tumor stage and nodal status) were strongly associated with clinical outcome.
authors.affiliation: Department of Radiotherapy, Institut Gustave Roussy Villejuif France.
authors.forename: J
authors.initials: J
authors.lastname: Bourhis
authors.forename: R
authors.initials: R
authors.lastname: Dendale
authors.forename: C
authors.initials: C
authors.lastname: Hill
authors.forename: J
authors.initials: J
authors.lastname: Bosq
authors.forename: F
authors.initials: F
authors.lastname: Janot
authors.forename: P
authors.initials: P
authors.lastname: Attal
authors.forename: A
authors.initials: A
authors.lastname: Fortin
authors.forename: P
authors.initials: P
authors.lastname: Marandas
authors.forename: G
authors.initials: G
authors.lastname: Schwaab
authors.forename: P
authors.initials: P
authors.lastname: Wibault
authors.forename: E P
authors.initials: EP
authors.lastname: Malaise
authors.forename: S
authors.initials: S
authors.lastname: Bobin
authors.forename: B
authors.initials: B
authors.lastname: Luboinski
authors.forename: F
authors.initials: F
authors.lastname: Eschwege
authors.forename: G
authors.initials: G
authors.lastname: Wilson
mesh_terms: D001973:Bromodeoxyuridine / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000532:radiotherapy*; D002455:Cell Division; D018572:Disease-Free Survival; D005260:Female; D005434:Flow Cytometry; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000532:radiotherapy*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology / Q000532:radiotherapy; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D013997:Time Factors; D017211:Treatment Failure
chemical_list: D001973:Bromodeoxyuridine