title: Nuclear NF-κB expression correlates with outcome among patients with head and neck squamous cell carcinoma treated with primary chemoradiation therapy.
abstract: BACKGROUND
  To examine whether nuclear NF-κB expression correlates with outcome in patients with head and neck squamous cell carcinoma (HNSCC) treated with primary chemoradiation therapy (CRT).
  
  
  METHODS
  Between 2007 and 2010, 101 patients with locally advanced primary HNSCC were treated with definitive simultaneous CRT. Pretreatment biopsy specimens were analyzed for NF-κB p65 (RelA) nuclear immunoreactivity. A sample was assigned to be positive with more than 5% positive nuclear expression. The predictive relevance of NF-κB and clinicopathologic factors for overall survival (OS), progression-free survival (PFS), local progression-free survival (LPFS), and metastasis-free survival (DMFS) was examined by univariate and multivariate analysis.
  
  
  RESULTS
  No significant differences between the groups were observed with regard to age, sex, total radiation dose, fractionation mode, total chemotherapy applied, T stage or grading. Patients with p65 nuclear positive biopsy specimens showed significantly a higher rate of lymph node metastasis (cN2c or cN3 status, P=.034). Within a mean follow-up time of 25 months (range, 2.33-62.96 months) OS, PFS, and DMFS were significantly poorer in the p65 nuclear positive group (P=.008, P=.027, and P=.008, respectively). These correlations remained significant in multivariate analysis.
  
  
  CONCLUSIONS
  NF-κB/p65 nuclear expression is associated with increased lymphatic and hematogenous tumor dissemination and decreased survival in HNSCC patients treated with primary CRT. Our results may foster further investigation of a predictive relevance of NF-κB/p65 and its role as a suitable target for a molecular-based targeted therapy in HNSCC cancer.
authors.affiliation: Department of Radiation Therapy and Oncology, J. W. Goethe - University Frankfurt am Main, Frankfurt, Germany.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Balermpas
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Michel
authors.forename: Jens
authors.initials: J
authors.lastname: Wagenblast
authors.forename: Oliver
authors.initials: O
authors.lastname: Seitz
authors.forename: Florian
authors.initials: F
authors.lastname: Sipek
authors.forename: Franz
authors.initials: F
authors.lastname: Rödel
authors.forename: Claus
authors.initials: C
authors.lastname: Rödel
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Fokas
mesh_terms: D000704:Analysis of Variance; D002294:Carcinoma, Squamous Cell / Q000378:metabolism / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy / Q000009:adverse effects / Q000379:methods*; D018450:Disease Progression; D019583:Dose Fractionation, Radiation; D005260:Female; D006258:Head and Neck Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016328:NF-kappa B / Q000378:metabolism; D009363:Neoplasm Proteins / Q000378:metabolism*; D015996:Survival Rate; D051996:Transcription Factor RelA / Q000378:metabolism*; D016896:Treatment Outcome
chemical_list: D016328:NF-kappa B; D009363:Neoplasm Proteins; D051996:Transcription Factor RelA