Hypoxia inducible factor-1 alpha and vascular endothelial growth factor expression are associated with a poor prognosis in patients with nasopharyngeal carcinoma receiving radiotherapy with carbogen and nicotinamide.
OBJECTIVE
Hypoxia reduces tumour radiosensitivity and hypoxia inducible factor-1 alpha (HIF-1 alpha) plays an important role in this process. The aim of the study was to assess the prognostic impact of HIF-1 alpha and vascular endothelial growth factor (VEGF) in patients with nasopharyngeal carcinoma who received radiation with hypoxia-modifying therapy (carbogen plus nicotinamide).


METHODS
The immunohistochemical expression of HIF-1 alpha and VEGF was evaluated in nasopharyngeal carcinoma biopsies from 59 patients who received conventional radiotherapy combined with carbogen and nicotinamide.


RESULTS
A significant positive association was found between HIF-1 alpha and VEGF expression (P = 0.003). There was no association found between the level of HIF-1 alpha, VEGF expression and tumour stage, nodal stage, or clinical stage. Kaplan-Meier plots showed that positive HIF-1 alpha and VEGF expression were associated with a higher distant metastasis, a worse overall and disease-free survival, and the level of HIF-1 alpha and VEGF expression had no effect on locoregional recurrence. The multivariate analysis failed to confirm any association between HIF-1 alpha or VEGF and metastasis, disease-free or overall survival.


CONCLUSIONS
These results suggest that the expression of hypoxia-associated markers (HIF-1 alpha and VEGF) may have prognostic significance in patients with nasopharyngeal carcinoma who receive radiation plus carbogen and nicotinamide, but further study is needed.
Xueguan
Lu
L
Department of Radiation Oncology, Second Affiliated Hospital of Soochow University, Suzhou, China. luxueguanok@yahoo.com.cn
Xiaoshen
Wang
W
Yongsheng
Zhang
Z
Chaosu
Hu
H
Chunying
Shen
S
Yan
Feng
F
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D002245:Carbon Dioxide / Q000627:therapeutic use*; D005260:Female; D015870:Gene Expression; D006801:Humans; D051795:Hypoxia-Inducible Factor 1, alpha Subunit; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000188:drug therapy / Q000378:metabolism* / Q000532:radiotherapy; D009536:Niacinamide / Q000627:therapeutic use*; D010100:Oxygen / Q000627:therapeutic use*; D011379:Prognosis; D011838:Radiation-Sensitizing Agents / Q000627:therapeutic use; D016019:Survival Analysis; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*
D015415:Biomarkers; D051795:Hypoxia-Inducible Factor 1, alpha Subunit; D011838:Radiation-Sensitizing Agents; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D002245:Carbon Dioxide; D009536:Niacinamide; C011700:carbogen; D010100:Oxygen