TUMOR HYPOXIA ADVERSELY AFFECTS THE PROGNOSIS OF CARCINOMA OF THE HEAD AND NECK

Purpose: Tumor hypoxia adversely affects short term clinical radiation response of head and neck cancer lymph node metastases and long term disease-free survival (DFS) in cervix carcinoma, This study was perfor med to evaluate the relationship between tumor hypoxia and DFS in pati ents with squamous carcinoma of the head and neck (SCCHN). Methods and Materials: Pretreatment tumor pO(2) was assessed polarographically in SCCHN patients, All patients were AJCC Stage IV and had pretreatment oxygen measurements taken from locally advanced primaries (T3 or T4) o r neck nodes greater than or equal to 1.5 cm diameter, Treatment consi sted of once daily (2 Gy/day to 66-70 Gy) or twice daily irradiation ( 1.25 Gy B.I.D. to 70-75 Gy) +/- planned neck dissection (for greater t han or equal to N2A disease) according to institutional treatment prot ocols. Results: Twenty-eight patients underwent tumor pO(2) measuremen t, The average pre-treatment median pO(2) was 11.2 mm Hg (range 0.4-60 mm Hg), The DFS at 12 months was 42%. The DFS was 78% for patients wi th median tumor pO(2) > 10 mm Hg but only 22% for median pO(2) < 10 mm Hg (p = 0.009). The average tumor median pO(2) for relapsing patients was 4.1 mm Hg and 17.1 mm Hg in non-relapsing (NED) patients (p = 0.0 07). Conclusion: Tumor hypoxia adversely affected the prognosis of pat ients in this study, Understanding of the mechanistic relationship bet ween hypoxia and treatment outcome will allow for the development of n ew and rational treatment programs in the future. (C) 1997 Elsevier Sc ience Inc.