title: Molecular biomarkers and site of first recurrence after radiotherapy for head and neck cancer.
abstract: The prognostic significance of a panel of molecular biomarkers in head and neck squamous cell carcinoma (HNSCC) for first failure site (primary (T), nodal (N) or distant (M)) was analysed in 309 patients randomised to continuous hyperfractionated accelerated radiotherapy (CHART) vs. conventionally fractionated radiotherapy. Multivariate competing risks analysis was performed using an accelerated failure-time model. First-order interactions between each marker and trial arm were also tested. Bcl2-positivity increased the time to T- and N-failures, increasing cyclin D1 score decreased the time to N-failures. A random proliferative pattern and low Ki-67 decreased the time to M-failures. A high CD31 score was associated with a significantly longer time to T-failure after CHART, but not after conventional fractionation. Risks of T-, N- and M-failures could be estimated for individual patients. Competing risks analysis of failure sites allows the rational selection of patients for more aggressive loco-regional or systemic therapy.
authors.affiliation: Gray Cancer Institute, Group for Human Cancer Biology and Informatics, Mount Vernon Hospital, Northwood, Middlesex HA6 2JR, UK.
authors.forename: Ozlem U
authors.initials: OU
authors.lastname: Ataman
authors.forename: Søren M
authors.initials: SM
authors.lastname: Bentzen
authors.forename: George D
authors.initials: GD
authors.lastname: Wilson
authors.forename: Frances M
authors.initials: FM
authors.lastname: Daley
authors.forename: Paul I
authors.initials: PI
authors.lastname: Richman
authors.forename: Michele I
authors.initials: MI
authors.lastname: Saunders
authors.forename: Stanley
authors.initials: S
authors.lastname: Dische
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism*; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D004812:Epidemiologic Methods; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D011379:Prognosis; D017211:Treatment Failure
chemical_list: D014408:Biomarkers, Tumor