Jh. Hwang et al., Apoptosis and bcl-2 expression as predictors of survival in radiation-treated non-small-cell lung cancer, INT J RAD O, 50(1), 2001, pp. 13-18
Citations number
29
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Onconogenesis & Cancer Research
Journal title
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
Objectives: We assessed the role of apoptosis and the expression of bcl-2,
p53, and c-myc oncoproteins in pretreatment histologic specimens as a predi
ctor of response to radiation therapy and survival in non-small-cell lung c
ancer (NSCLC) patients.
Methods: Pretreatment biopsy specimens of 68 patients with NSCLC (62 squamo
us cell carcinoma, 6 adenocarcinoma) were stained with hematoxylin and eosi
n, From 5 high-powered fields, the apoptotic index (AI) was calculated as t
he ratio of apoptotic tumor cells to the total number of tumor cells. Bcl-2
, p53, and c-myc oncoprotein expression was detected by immunohistochemical
staining.
Results: Twenty-nine cases showed partial or complete remission, whereas 39
showed no response. AI ranged from 0.2 to 12.0% (mean +/- SD; 4.3 +/- 2.6%
, median 4.0%), There was no difference in AI between responders (4.0 +/- 2
.3) and nonresponders (4.5 +/- 2.8, p > 0.05). However, in the responders,
AI was correlated with the degree of change in tumor volume (r = 0.41, p <
0.05). In an analysis of 53 subjects who survived more than I month after t
he completion of radiation therapy, the patients with a higher AI (n = 27,
MST = 22.8 m) survived longer than those with a fewer AI (n = 26, MST = 9.2
, log-rank, p = 0.03). Patients expressing bcl-2 had poorer survival (n = 2
2, MST = 6.0 m) than patients without bcl-2 (n = 31, 22.8 m,p < 0.003). Acc
ording to multivariate analysis, three variables, bcl-2 expression, AI, and
response to radiation, were independent prognostic factors for survival.
Conclusion: A low level of spontaneous apoptosis and expression of apoptosi
s blocking bcl-2 protein in pretreatment histology predict a poor prognosis
for radiation-treated NSCLC patients. (C) 2001 Elsevier Science Inc.