title: In vitro chemosensitivity profile of oral squamous cell cancer and its correlation with clinical response to chemotherapy.
abstract: BACKGROUND
  Oral cancers represent a disparate group of tumors with diverse clinical behavior and chemosensitivity profile. Currently, it is difficult to predict whether a tumor will respond to chemotherapy and which drug(s) will achieve the maximum clinical response.
  
  
  OBJECTIVE
  To study in vitro chemosensitivity profile of oral cancers and to correlate the in vitro chemosensitivity of oral cancer to clinical response to chemotherapy.
  
  
  METHODS
  Prospective study in a tertiary cancer care center.
  
  
  METHODS
  We prospectively studied the chemosensitivity profile of 57 untreated, advanced, unresectable oral cancers to cisplatin, methotrexate, 5-fluorouracil and their combinations by using histoculture drug response assay (HDRA) and correlated them to the clinical response to chemotherapy.
  
  
  METHODS
  Chi Square test.
  
  
  RESULTS
  Biopsy samples were successfully histocultured in 52/57 (91%) cases. Of these 52 evaluable patients, 47 had primary gingivo-buccal cancers and five had tongue / floor of mouth cancers. Based on the assay, 27 (52%) tumors were sensitive to cisplatin, 27 (52%) to methotrexate, 24 (46%) to 5-fluorouracil, 38 (73%) to combination of cisplatin and methotrexate and 36 (69%) to combination of cisplatin and 5-fluorouracil. Of these, 31 patients with good performance status received two cycles of chemotherapy using one or more of these test drugs. There was a significant correlation (p=0.03) between the in vitro chemosensitivity and the clinical response. Negative predictive value of the test was 80%, positive predictive value-69%, sensitivity-79% and specificity -71%. The overall accuracy of the assay was 74%.
  
  
  CONCLUSIONS
  We found HDRA to be a fairly good predictor of chemo-response of oral cancer.
authors.affiliation: Head and Neck Service, Department of Surgery, Tata Memorial Hospital, Parel, Mumbai, India. kapathak@rediffmail.com
authors.forename: K A
authors.initials: KA
authors.lastname: Pathak
authors.forename: A S
authors.initials: AS
authors.lastname: Juvekar
authors.forename: D K
authors.initials: DK
authors.lastname: Radhakrishnan
authors.forename: M S
authors.initials: MS
authors.lastname: Deshpande
authors.forename: V R
authors.initials: VR
authors.lastname: Pai
authors.forename: P
authors.initials: P
authors.lastname: Chaturvedi
authors.forename: P S
authors.initials: PS
authors.lastname: Pai
authors.forename: D A
authors.initials: DA
authors.lastname: Chaukar
authors.forename: A K
authors.initials: AK
authors.lastname: D'Cruz
authors.forename: P M
authors.initials: PM
authors.lastname: Parikh
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000494:pharmacology / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000494:pharmacology / Q000627:therapeutic use; D001681:Biological Assay; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy*; D002945:Cisplatin / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D005472:Fluorouracil / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D066298:In Vitro Techniques; D008297:Male; D008727:Methotrexate / Q000494:pharmacology / Q000627:therapeutic use; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000188:drug therapy*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D002945:Cisplatin; D005472:Fluorouracil; D008727:Methotrexate