title: Impact of Expression of CD44, a Cancer Stem Cell Marker, on the Treatment Outcomes of Intensity Modulated Radiation Therapy in Patients With Oropharyngeal Squamous Cell Carcinoma.
abstract: OBJECTIVE
  To investigate the significance of CD44 protein expression on the treatment outcomes of radiation therapy in patients with oropharyngeal squamous cell carcinoma (OPSCC) with or without p16 protein expression in the tumor tissue.
  
  
  METHODS
  We reviewed the medical records of 58 OPSCC patients who had undergone radiation therapy and examined the tumor tissue expressions of CD44 and p16 protein by immunohistochemical staining. The correlations between the expressions of these proteins and the patients' treatment outcomes were analyzed.
  
  
  RESULTS
  The data of 58 consecutive OPSCC patients who had undergone definitive intensity modulated radiation therapy were analyzed. The male/female ratio was 55:3, and the median age was 64 years. The clinical stage of the disease was stage II in 7 patients, stage III in 5 patients, stage IVA in 35 patients, and stage IVB in 11 patients. Of the patients, 79% received additional induction and/or concurrent chemotherapy. The median follow-up duration was 34 months. The 3-year overall survival, progression-free survival (PFS) and locoregional control (LRC) rates of all the patients, regardless of the results of immunohistochemistry, were 73%, 64% and 76%, respectively. The PFS and LRC rates in the CD44(-) patients (86% and 93%, respectively) were significantly higher than those in the CD44(+) patients (57% and 70%, respectively). The PFS and LRC rates in the p16(+) patients (83% and 90%, respectively) were significantly higher than those in the p16(-) patients (45% and 61%, respectively). Patients who were CD44(-)/p16(+) showed the best LRC rates, and those who were CD44(+)/p16(-) showed the worst PFS and LRC rates among all the groups.
  
  
  CONCLUSIONS
  Profiling of CD44 and p16 protein expressions by immunohistochemical staining is useful for predicting the treatment outcomes in patients with OPSCC undergoing definitive intensity modulated radiation therapy.
authors: Division of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan. Electronic address: amotegi@east.ncc.go.jp.
authors: Atsushi
authors: A
authors: Motegi
authors: Pathology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
authors: Satoshi
authors: S
authors: Fujii
authors: Division of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
authors: Sadamoto
authors: S
authors: Zenda
authors: Division of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
authors: Satoko
authors: S
authors: Arahira
authors: Division of Head and Neck Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
authors: Makoto
authors: M
authors: Tahara
authors: Division of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
authors: Ryuichi
authors: R
authors: Hayashi
authors: Division of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
authors: Tetsuo
authors: T
authors: Akimoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000378:metabolism* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000378:metabolism*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D018960:Hyaluronan Receptors / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D014411:Neoplastic Stem Cells / Q000378:metabolism; D009959:Oropharyngeal Neoplasms / Q000188:drug therapy / Q000378:metabolism* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods; D012044:Regression Analysis; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D019941:Cyclin-Dependent Kinase Inhibitor p16; D018960:Hyaluronan Receptors