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Article: Prognostic value of epidermal growth factor receptor expression in patients with advanced stage nasopharyngeal carcinoma treated with induction chemotherapy and radiotherapy

TitlePrognostic value of epidermal growth factor receptor expression in patients with advanced stage nasopharyngeal carcinoma treated with induction chemotherapy and radiotherapy
Authors
KeywordsEpidermal growth factor receptor
Induction chemotherapy
Nasopharyngeal carcinoma
Radiotherapy
Issue Date2004
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ijrobp
Citation
International Journal of Radiation Oncology - Biology - Physics, 2004, v. 59 n. 1, p. 11-20 How to Cite?
AbstractPurpose A retrospective study was performed to correlate the expression of epidermal growth factor receptor (EGFR) with treatment outcome in advanced stage nasopharyngeal carcinoma (NPC). Methods and materials The study population comprised 54 of 92 patients with American Joint Committee on Cancer Stage III-IV NPC with sufficient pretreatment tumor biopsy specimens for study. Immunohistochemical staining was performed to evaluate the extent and intensity of EGFR expression. All patients were treated by induction chemotherapy with two to three cycles of cisplatin 60 mg/m2 and epirubicin 110 mg/m 2 every 3 weeks followed by radiotherapy. The median follow-up time was 52 months for all patients and 99 months for surviving patients. Results EGFR expression was present in 89% of cases. EGFR intensity was negative in 11%, weak in 43%, moderate in 13%, and strong in 33%. The EGFR extent was <5% in 15%, ≥5% but <25% in 13%, and ≥25% in 72%. No correlation was found between EGFR expression and T stage, N stage, stage group, nodal size, gender, and age. No statistically significant differences in chemotherapy response rates were found in patients with different EGFR intensity and extent. EGFR extent ≥25% was associated with a significantly poorer treatment outcome. The 5-year disease-specific survival, relapse-free survival, locoregional relapse-free, and distant metastasis-free rate in patients with EGFR extent ≥25% was 48%, 36%, 60%, and 55%, respectively. The corresponding rates in patients with EGFR extent <25% were 86%, 80%, 93%, and 86%. The differences were all statistically significant, except for distant metastasis. No statistically significant differences in relapse-free and disease-specific survival rates were found among patients with differing EGFR intensity. In multivariate analysis, EGFR extent was the only independent factor that predicted for disease relapse, locoregional failure, and cancer death. Conclusion Our study results showed that EGFR expression was common in advanced stage NPC, and the expression did not correlate with tumor or nodal stage. Correlative analysis showed that EGFR extent was a strong, independent prognostic factor that determined locoregional control, relapse-free survival, and disease-specific survival in Stage III-IV NPC treated with induction chemotherapy and radiotherapy. Our findings suggest that EGFR expression status can identify a subgroup of patients within advanced stage disease that will have a poor outcome after induction chemotherapy and radiotherapy. Whether this patient subgroup will benefit from an alternate treatment strategy and anti-EGFR-targeted treatment requires additional studies. © 2004 Elsevier Inc.
Persistent Identifierhttp://hdl.handle.net/10722/88499
ISSN
2015 Impact Factor: 4.495
2015 SCImago Journal Rankings: 2.274
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChua, DTTen_HK
dc.contributor.authorNicholls, JMen_HK
dc.contributor.authorSham, JSTen_HK
dc.contributor.authorAu, GKHen_HK
dc.date.accessioned2010-09-06T09:44:10Z-
dc.date.available2010-09-06T09:44:10Z-
dc.date.issued2004en_HK
dc.identifier.citationInternational Journal of Radiation Oncology - Biology - Physics, 2004, v. 59 n. 1, p. 11-20en_HK
dc.identifier.issn0360-3016en_HK
dc.identifier.urihttp://hdl.handle.net/10722/88499-
dc.description.abstractPurpose A retrospective study was performed to correlate the expression of epidermal growth factor receptor (EGFR) with treatment outcome in advanced stage nasopharyngeal carcinoma (NPC). Methods and materials The study population comprised 54 of 92 patients with American Joint Committee on Cancer Stage III-IV NPC with sufficient pretreatment tumor biopsy specimens for study. Immunohistochemical staining was performed to evaluate the extent and intensity of EGFR expression. All patients were treated by induction chemotherapy with two to three cycles of cisplatin 60 mg/m2 and epirubicin 110 mg/m 2 every 3 weeks followed by radiotherapy. The median follow-up time was 52 months for all patients and 99 months for surviving patients. Results EGFR expression was present in 89% of cases. EGFR intensity was negative in 11%, weak in 43%, moderate in 13%, and strong in 33%. The EGFR extent was <5% in 15%, ≥5% but <25% in 13%, and ≥25% in 72%. No correlation was found between EGFR expression and T stage, N stage, stage group, nodal size, gender, and age. No statistically significant differences in chemotherapy response rates were found in patients with different EGFR intensity and extent. EGFR extent ≥25% was associated with a significantly poorer treatment outcome. The 5-year disease-specific survival, relapse-free survival, locoregional relapse-free, and distant metastasis-free rate in patients with EGFR extent ≥25% was 48%, 36%, 60%, and 55%, respectively. The corresponding rates in patients with EGFR extent <25% were 86%, 80%, 93%, and 86%. The differences were all statistically significant, except for distant metastasis. No statistically significant differences in relapse-free and disease-specific survival rates were found among patients with differing EGFR intensity. In multivariate analysis, EGFR extent was the only independent factor that predicted for disease relapse, locoregional failure, and cancer death. Conclusion Our study results showed that EGFR expression was common in advanced stage NPC, and the expression did not correlate with tumor or nodal stage. Correlative analysis showed that EGFR extent was a strong, independent prognostic factor that determined locoregional control, relapse-free survival, and disease-specific survival in Stage III-IV NPC treated with induction chemotherapy and radiotherapy. Our findings suggest that EGFR expression status can identify a subgroup of patients within advanced stage disease that will have a poor outcome after induction chemotherapy and radiotherapy. Whether this patient subgroup will benefit from an alternate treatment strategy and anti-EGFR-targeted treatment requires additional studies. © 2004 Elsevier Inc.en_HK
dc.languageengen_HK
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/ijrobpen_HK
dc.relation.ispartofInternational Journal of Radiation Oncology - Biology - Physicsen_HK
dc.rightsInternational Journal of Radiation: Oncology - Biology - Physics. Copyright © Elsevier Inc.en_HK
dc.subjectEpidermal growth factor receptoren_HK
dc.subjectInduction chemotherapyen_HK
dc.subjectNasopharyngeal carcinomaen_HK
dc.subjectRadiotherapyen_HK
dc.subject.meshAdulten_HK
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols - therapeutic useen_HK
dc.subject.meshCisplatin - administration & dosageen_HK
dc.subject.meshCombined Modality Therapyen_HK
dc.subject.meshEpirubicin - administration & dosageen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHumansen_HK
dc.subject.meshMaleen_HK
dc.subject.meshNasopharyngeal Neoplasms - drug therapy - metabolism - pathology - radiotherapyen_HK
dc.subject.meshNeoplasm Proteins - metabolismen_HK
dc.subject.meshNeoplasm Stagingen_HK
dc.subject.meshProportional Hazards Modelsen_HK
dc.subject.meshRadiotherapy Dosageen_HK
dc.subject.meshReceptor, Epidermal Growth Factor - metabolismen_HK
dc.subject.meshRetrospective Studiesen_HK
dc.subject.meshTreatment Outcomeen_HK
dc.titlePrognostic value of epidermal growth factor receptor expression in patients with advanced stage nasopharyngeal carcinoma treated with induction chemotherapy and radiotherapyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0360-3016&volume=59&spage=11&epage=20&date=2004&atitle=Prognostic+Value+of+Epidermal+Growth+factor+Receptor+Expression+in+Patients+with+Advanced+Stage+Nasopharyngeal+Carcinoma+Treated+with+Induction+Chemotherapy+and+Radiotherapyen_HK
dc.identifier.emailChua, DTT: dttchua@hkucc.hku.hken_HK
dc.identifier.emailNicholls, JM: jmnichol@hkucc.hku.hken_HK
dc.identifier.authorityChua, DTT=rp00415en_HK
dc.identifier.authorityNicholls, JM=rp00364en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.ijrobp.2003.10.038en_HK
dc.identifier.pmid15093894-
dc.identifier.scopuseid_2-s2.0-4644345181en_HK
dc.identifier.hkuros88034en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-4644345181&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume59en_HK
dc.identifier.issue1en_HK
dc.identifier.spage11en_HK
dc.identifier.epage20en_HK
dc.identifier.isiWOS:000221047500004-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridChua, DTT=7006773480en_HK
dc.identifier.scopusauthoridNicholls, JM=7201463077en_HK
dc.identifier.scopusauthoridSham, JST=7101655565en_HK
dc.identifier.scopusauthoridAu, GKH=7003748615en_HK

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