TREATMENT OF ORAL CAVITY AND OROPHARYNX SQUAMOUS-CELL CARCINOMA WITH PERILYMPHATIC INTERLEUKIN-2 - CLINICAL AND PATHOLOGICAL CORRELATIONS

We describe the correlations between the clinical and histologic findi ngs in an initial series of 60 patients with T2-4, NO-3, MO squamous c ell carcinoma (SCC) of the oral cavity or oropharynx enrolled in a ran domized trial set up to evaluate whether the disease-free interval and survival are extended when perilymphatic injections of recombinant in terleukin-2 (rIL-2) are combined with routine surgery and radiotherapy . Twenty-nine patients were operated on only (controls). The other 31 received two daily injections of 2,500 U rIL-2, one near the mastoid p rocess on the same side as the tumor and the other under the chin, for 10 days before surgery, and further injections on the nonoperated-on side on a monthly basis for 1 year starting 4 weeks after surgery (or radiotherapy, where necessary) in an effort to upregulate the immune s ystem and delay recurrence. Their surgical specimens displayed a signi ficantly greater inflammatory reaction, larger areas of necrosis, and more intense sclerosis. The inflammatory tumor infiltration consisted of eosinophils, plasma cells, and CD25(+) and human leukocyte antigen (HLA)-DR(+) lymphocytes. However, no correlations were apparent with r egard to the intensity of necrosis, eosinophil infiltration, and the n umber of DR(+) cells and the clinical outcome. By contrast, the correl ation between CD25(+) cells and a significantly longer disease-free su rvival suggests that induction of T-cell reactivity, and perhaps speci fic immunity, is the only important aspect of rIL-2-induced antitumor reactivity.