title: Tumor hypoxia adversely affects the prognosis of carcinoma of the head and neck.
abstract: OBJECTIVE
  Tumor hypoxia adversely affects short term clinical radiation response of head and neck cancer lymph node metastases and long term disease-free survival (DFS) in cervix carcinoma. This study was performed to evaluate the relationship between tumor hypoxia and DFS in patients with squamous carcinoma of the head and neck (SCCHN).
  
  
  METHODS
  Pretreatment tumor pO2 was assessed polarographically in SCCHN patients. All patients were AJCC Stage IV and had pretreatment oxygen measurements taken from locally advanced primaries (T3 or T4) or neck nodes > or = 1.5 cm diameter. Treatment consisted of once daily (2 Gy/day to 66-70 Gy) or twice daily irradiation (1.25 Gy B.I.D. to 70-75 Gy) +/- planned neck dissection (for > or = N2A disease) according to institutional treatment protocols.
  
  
  RESULTS
  Twenty-eight patients underwent tumor pO2 measurement. The average pre-treatment median pO2 was 11.2 mm Hg (range 0.4-60 mm Hg). The DFS at 12 months was 42%. The DFS was 78% for patients with median tumor pO2 > 10 mm Hg but only 22% for median pO2 < 10 mm Hg (p = 0.009). The average tumor median pO2 for relapsing patients was 4.1 mm Hg and 17.1 mm Hg in non-relapsing (NED) patients (p = 0.007).
  
  
  CONCLUSIONS
  Tumor hypoxia adversely affected the prognosis of patients in this study. Understanding of the mechanistic relationship between hypoxia and treatment outcome will allow for the development of new and rational treatment programs in the future.
authors.affiliation: Department of Radiation Oncology, Duke University Medical Center, Durham, NC 27710, USA. brizel@radonc.duke.edu
authors.forename: D M
authors.initials: DM
authors.lastname: Brizel
authors.forename: G S
authors.initials: GS
authors.lastname: Sibley
authors.forename: L R
authors.initials: LR
authors.lastname: Prosnitz
authors.forename: R L
authors.initials: RL
authors.lastname: Scher
authors.forename: M W
authors.initials: MW
authors.lastname: Dewhirst
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000503:physiopathology / Q000532:radiotherapy*; D015687:Cell Hypoxia / Q000502:physiology*; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000532:radiotherapy*; D006801:Humans; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D017211:Treatment Failure