title: Vascular endothelial growth factor expression predicts outcome after primary radiotherapy for head and neck squamous cell cancer.
abstract: OBJECTIVE
  To establish whether the expression of vascular endothelial growth factors (VEGFs) predicts prognosis in patients treated with primary radiotherapy for cancers of the upper aerodigestive tract.
  
  
  METHODS
  A retrospective analysis was undertaken of VEGF and VEGF-D expression in tumour tissue in pre-treatment biopsies from 27 patients who had been treated with primary radiotherapy for stage II-IV squamous head and neck carcinomas. Serial sections (4 microm) were cut from formalin-fixed, paraffin-embedded specimens and stained with monoclonal antibodies using standard immunoperoxidase methods. Two independent investigators assessed the staining intensity in a randomised, blind manner. Both negative and positive controls (placenta and/or tonsil) were included in the staining procedure. All patients were followed for a minimum of 5 years, or until death. Local control and overall survival were taken as end points for the comparative analysis between patients whose tumours expressed low levels and those that expressed high levels of the two growth factors. Comparisons were made using the Log-rank test with Kaplan-Meier actuarial survival analysis.
  
  
  RESULTS
  In patients with tumours expressing low levels of VEGF, 5-year local control was seen in 75% compared with 18% for those with high levels; overall survival was 75 and 23%, respectively. For those with low levels of VEGF-D, 5-year local control was 64% compared with 17% for those with high levels; overall survival was 58 and 20%, respectively.
  
  
  CONCLUSIONS
  Our results suggest that the expression of endothelial growth factors in squamous head and neck cancers may predict outcome after radiotherapy.
authors.affiliation: Department of Clinical Oncology, School of Molecular Medical Sciences, University of Nottingham, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK.
authors.forename: S G
authors.initials: SG
authors.lastname: Martin
authors.forename: C
authors.initials: C
authors.lastname: Orridge
authors.forename: A
authors.initials: A
authors.lastname: Mukherjee
authors.forename: D A L
authors.initials: DA
authors.lastname: Morgan
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000378:metabolism / Q000401:mortality / Q000532:radiotherapy*; D006258:Head and Neck Neoplasms / Q000378:metabolism / Q000401:mortality / Q000532:radiotherapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D042643:Vascular Endothelial Growth Factor D / Q000378:metabolism* / Q000528:radiation effects; D042442:Vascular Endothelial Growth Factors / Q000378:metabolism* / Q000528:radiation effects
chemical_list: D042643:Vascular Endothelial Growth Factor D; D042442:Vascular Endothelial Growth Factors