title: Nuclear expression of p65 (RelA) in patients receiving post-operative radiotherapy for locally advanced squamous cell carcinoma of the head and neck.
abstract: BACKGROUND
  This study investigated the prognostic role of nuclear expression of p65 in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN) receiving post-operative radio(chemo)therapy.
  
  
  METHODS
  Nuclear p65-expression (H-score ≤50 versus >50) plus twelve characteristics were analyzed in 151 patients for overall survival (OS), metastases-free survival (MFS) and loco-regional control (LRC). Additional characteristics included age, gender, Karnofsky performance score (KPS), pre-radiotherapy hemoglobin levels, tumor site, histological grading, human papilloma virus (HPV)-status, T-classification, N-classification, American Joint Committee on Cancer (AJCC)-stage, extent of resection and concurrent chemotherapy. Univariate analyses were performed with Kaplan-Meier method and log-rank test, multivariate analyses with Cox proportional hazards model.
  
  
  RESULTS
  On univariate analyses, p65-expression had a significant impact on OS (p < 0.001) and LRC (p < 0.001) but not on MFS (p = 0.29). On multivariate analysis, KPS ≥80 (risk ratio [RR] 2.23; p = 0.012), HPV-positivity (RR 5.83; p = 0.020), T1-T2 (RR 1.38; p = 0.048), N0-N2a (RR 2.72; p = 0.005) and complete resection (RR 2.02; p = 0.049) were positively associated with OS; p65-negativity achieved borderline significance (RR 3.02; p = 0.052). Better MFS was associated with KPS ≥80 (RR 2.49; p = 0.015), T1-T2 (RR: 1.74; p = 0.005), N0-N2a (RR: 6.22; p < 0.001) and complete resection (RR 3.43; p = 0.003). Positive associations with LRC were found for p65-negativity (RR 5.06; p = 0.008), T1-T2 (RR: 1.49; p = 0.022), N0-N2a (RR: 2.97; p = 0.004) and favorable tumor site (RR 1.28; p = 0.025).
  
  
  CONCLUSIONS
  P65-negativity was significantly associated with improved LRC and achieved borderline significance with respect to improved OS. Thus, p65-expression may be an additional target for novel agents in the treatment of locally advanced SCCHN.
authors: Dirk
authors: D
authors: Rades
authors: Stefan
authors: S
authors: Huttenlocher
authors: Nina D
authors: ND
authors: Seibold
authors: Maximilian P
authors: MP
authors: Gebhard
authors: Christoph
authors: C
authors: Thorns
authors: Katrin
authors: K
authors: Hasselbacher
authors: Barbara
authors: B
authors: Wollenberg
authors: Steven E
authors: SE
authors: Schild
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000378:metabolism* / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D002467:Cell Nucleus / Q000378:metabolism*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D015870:Gene Expression; D006258:Head and Neck Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D006801:Humans; D007150:Immunohistochemistry; D017567:Karnofsky Performance Status; D009367:Neoplasm Staging; D000077195:Squamous Cell Carcinoma of Head and Neck; D016019:Survival Analysis; D051996:Transcription Factor RelA / Q000235:genetics / Q000378:metabolism*; D016896:Treatment Outcome
chemical_list: D051996:Transcription Factor RelA