Abstract | BACKGROUND: Recent advances in radiation technology has allowed to significantly reduce toxicity and improve the efficacy of radical radiotherapy in head and neck and oral squamous cell cancers. Insights into molecular biology of carcinogenesis has opened a window for identifying aggressive clinical situations that may benefit with larger clinical target volume (CTV ) margin, broader levels of nodal coverage, or alternative radiation sensitizers. AIM: MATERIAL AND METHODS: RESULTS: In oral cancers, 27 patients (67.5%) were positive for p53 and 10 (25%) for eIF4E in surgically negative margins. For head and neck cancer, the values were 13 (50%) for p53 and 9 (34.6%) for eIF4E. Twelve patients with oral cancers and 8 patients with head and neck cancers had local failure or death. The association with these biomarkers did not achieve statistical significance. However, adjuvant radiotherapy had a significant protective value. It improved median survival from 15 to 21 months in patients positive for p53 (P = 0.018) and from 12 to 20 months (P = 0.03) in those with eIF4E. There was no predictive association of subsite, tumor size, or nodal status. CONCLUSION: The overexpression of p53 and eIF4E in pathologically negative margins may represent a subset of patients who would benefit from early initiation of adjuvant radiation and tailored intensity-modulated radiotherapy (IMRT).
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Authors | Bindhu Joseph, Rekha V Kumar, G Champaka, Ashok Shenoy, K S Sabitha, V Lokesh, C Ramesh, C R Vijay |
Journal | Indian journal of cancer
(Indian J Cancer)
2019 Oct-Dec
Vol. 56
Issue 4
Pg. 330-334
ISSN: 1998-4774 [Electronic] India |
PMID | 31607702
(Publication Type: Journal Article)
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Chemical References |
- Biomarkers
- Eukaryotic Initiation Factor-4E
- Tumor Suppressor Protein p53
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Biomarkers
(metabolism)
- Carcinoma, Squamous Cell
(mortality, radiotherapy)
- Eukaryotic Initiation Factor-4E
(metabolism)
- Female
- Head and Neck Neoplasms
(mortality, radiotherapy)
- Humans
- Male
- Middle Aged
- Mouth Neoplasms
(mortality, radiotherapy)
- Patient Selection
- Prognosis
- Prospective Studies
- Radiotherapy, Adjuvant
(methods)
- Survival Analysis
- Treatment Outcome
- Tumor Suppressor Protein p53
(metabolism)
- Young Adult
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