Angiogenesis vs. response after combined chemoradiotherapy of squamous cell head and neck cancer
Alexandra Giatromanolaki
Tumour and Angiogenesis Research Group, Iraklion, Crete, Greece
Laboratory of Tumour Cell Biology, University Hospital of Iraklion, Iraklion, Crete, Greece
Search for more papers by this authorCorresponding Author
Michael I. Koukourakis
Tumour and Angiogenesis Research Group, Iraklion, Crete, Greece
Laboratory of Tumour Cell Biology, University Hospital of Iraklion, Iraklion, Crete, Greece
Tumour and Angiogenesis Research Group, 18 Dimokratias Avenue, Iraklion 71306, Crete, Greece. Fax: 0030-81-392848.Search for more papers by this authorVassilis Georgoulias
Laboratory of Tumour Cell Biology, University Hospital of Iraklion, Iraklion, Crete, Greece
Search for more papers by this authorKevin C. Gatter
Tumour and Angiogenesis Research Group, Iraklion, Crete, Greece
Department of Cellular Science and ICRF Medical Oncology Unit, Oxford Radcliffe Hospital, Headington, Oxford, UK
Search for more papers by this authorAdrian L. Harris
Tumour and Angiogenesis Research Group, Iraklion, Crete, Greece
Department of Cellular Science and ICRF Medical Oncology Unit, Oxford Radcliffe Hospital, Headington, Oxford, UK
Search for more papers by this authorGeorge Fountzilas
Department of Medical Oncology, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
Search for more papers by this authorAlexandra Giatromanolaki
Tumour and Angiogenesis Research Group, Iraklion, Crete, Greece
Laboratory of Tumour Cell Biology, University Hospital of Iraklion, Iraklion, Crete, Greece
Search for more papers by this authorCorresponding Author
Michael I. Koukourakis
Tumour and Angiogenesis Research Group, Iraklion, Crete, Greece
Laboratory of Tumour Cell Biology, University Hospital of Iraklion, Iraklion, Crete, Greece
Tumour and Angiogenesis Research Group, 18 Dimokratias Avenue, Iraklion 71306, Crete, Greece. Fax: 0030-81-392848.Search for more papers by this authorVassilis Georgoulias
Laboratory of Tumour Cell Biology, University Hospital of Iraklion, Iraklion, Crete, Greece
Search for more papers by this authorKevin C. Gatter
Tumour and Angiogenesis Research Group, Iraklion, Crete, Greece
Department of Cellular Science and ICRF Medical Oncology Unit, Oxford Radcliffe Hospital, Headington, Oxford, UK
Search for more papers by this authorAdrian L. Harris
Tumour and Angiogenesis Research Group, Iraklion, Crete, Greece
Department of Cellular Science and ICRF Medical Oncology Unit, Oxford Radcliffe Hospital, Headington, Oxford, UK
Search for more papers by this authorGeorge Fountzilas
Department of Medical Oncology, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
Search for more papers by this authorAbstract
Oxygen/drug supply to cancer cells is an important factor defining response to radiotherapy and chemotherapy. Although tumor angiogenesis is considered an important prognostic marker, its role in the outcome of chemotherapy and radiotherapy is unknown. In the present study we examined the possible correlation of the degree of angiogenesis with response to cytotoxic therapy in locally advanced squamous cell head and neck cancer (HNC). Vascular grade (VG) was assessed immunohistochemically using the JC70 monoclonal antibody (MAb) in tumor specimens from 76 patients treated with platinum/5-fluorouracil (with or without methotrexate) induction chemotherapy (ICT) (n = 37) or concurrent chemoradiotherapy (CCRT) with cisplatin or carboplatin (n = 39). Seventeen of 76 analyzed patients had an overall microvessel score of <11 (VG1), 25/76 of 11–30 (VG2), 16/76 of 31–50 (VG3) and 18/76 of >50 (VG4). Complete response rate after ICT or after CCRT was higher in cases with an intermediate vascularization (VG2,3). Both local relapse-free and overall survival were significantly better in the VG2 group. Patients treated with CCRT had a better survival compared to those treated with ICT. This was mainly observed in VG1 tumors. Multivariate analysis showed that VG and treatment modality were independent prognostic factors for local relapse and survival. Intratumoral angiogenesis correlation with the cytotoxic therapy outcome is likely to follow a bell-shaped relation, the response being better in cases with an intermediate VG. This may be the consequence of 2 vasculature-dependent factors, i.e., the drug/oxygen availability and the ability of cancer cells to undergo rapid repopulation in optimally oxygenated conditions. Our pilot study stresses the importance of individualization of therapy according to VG. Int. J. Cancer 80:810–817, 1999. © 1999 Wiley-Liss, Inc.
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