title: The relationship of epidermal growth factor receptor levels to the prognosis of unresectable pharyngeal cancer patients treated by chemo-radiotherapy.
abstract: The aim of this study was to analyse prognostic factors for time to treatment failure (TTF) and overall survival (OS) in patients with unresectable cancer of the pharynx. A twice daily (b.i.d.) radiotherapy with concomitant cisplatin-5-fluorouracil chemotherapy was administered to 77 consecutive patients (68 males, 9 females; median age: 56 years). The studied factors were: age, gender, tumour differentiation, tumour volume, initial hemoglobin level, karnofsky index (KI), primary tumour location, T, N, epidermal growth factor receptor (EGFR) level in the tumour (fmol/mg protein). KI and EGFR level were significant predictors in a multivariate analysis for TTF (P=0.004 and P=0.0001) and OS (P=0.004 and P=0.0001). In order to select subgroups with different outcomes, a stratification of patients was performed based on the EGFR value: patients with tumour EGFR levels <35 fmol/mg protein, between 35 and 275 fmol/mg protein and >275 fmol/mg protein had 95%, 51% and 16% 3 year OS rates, respectively (log rank test; P=0.0001). Interestingly, for patients exhibiting a complete response (CR) after concomitant b.i.d. chemo-radiotherapy, patients with EGFR levels <35 fmol/mg protein were all alive at 3 years; in contrast, there was only 70 and 13% 3 year survival rates for patients with EGFR tumour levels between 35 and 275 fmol/mg protein and above 275 fmol/mg protein, respectively. EGFR determination appears to be a powerful prognostic parameter in unresectable pharyngeal cancer patients treated by concomitant chemo-radiotherapy.
authors.affiliation: Department of Radiotherapy, Centre Antoine Lacassagne, 33 Avenue de Valombrose, 06189 Nice Cedex 2, France.
authors.forename: N
authors.initials: N
authors.lastname: Magné
authors.forename: X
authors.initials: X
authors.lastname: Pivot
authors.forename: R J
authors.initials: RJ
authors.lastname: Bensadoun
authors.forename: E
authors.initials: E
authors.lastname: Guardiola
authors.forename: G
authors.initials: G
authors.lastname: Poissonnet
authors.forename: O
authors.initials: O
authors.lastname: Dassonville
authors.forename: M
authors.initials: M
authors.lastname: Francoual
authors.forename: J L
authors.initials: JL
authors.lastname: Formento
authors.forename: F
authors.initials: F
authors.lastname: Demard
authors.forename: M
authors.initials: M
authors.lastname: Schneider
authors.forename: G
authors.initials: G
authors.lastname: Milano
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000378:metabolism* / Q000532:radiotherapy; D003131:Combined Modality Therapy; D066246:ErbB Receptors / Q000378:metabolism*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000378:metabolism; D010610:Pharyngeal Neoplasms / Q000188:drug therapy / Q000378:metabolism* / Q000532:radiotherapy; D011379:Prognosis; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins; D066246:ErbB Receptors