Patterns and Levels of Hypoxia in Head and Neck Squamous Cell Carcinomas and Their Relationship to Patient Outcome

Journal Article · Thu Nov 15 04:00:00 EST 2007 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2007.04.067· OSTI ID:21039612

Evans, Sydney M. V. , ^[1]; Du, Kevin L ^[1]; Chalian, Ara A ^[2]; Mick, Rosemarie ^[3]; Zhang, Paul J ^[4]; Hahn, Stephen M; Quon, Harry; Lustig, Robert ^[1]; Weinstein, Gregory S ^[2]; Koch, Cameron J ^[1]

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1. Department of Radiation Oncology, School of Medicine, University of Pennsylvania, Philadelphia, PA (United States)
2. Department of Otorhinolaryngology, School of Medicine, University of Pennsylvania, Philadelphia, PA (United States)
3. Department of Biostatistics and Epidemiology, School of Medicine, University of Pennsylvania, Philadelphia, PA (United States)
4. Department of Pathology, School of Medicine, University of Pennsylvania, Philadelphia, PA (United States)

Purpose: EF5, a 2-nitroimidazole hypoxia marker, was used to study the presence, levels, and prognostic significance of hypoxia in primary head and neck squamous cell tumors. Methods and Materials: Twenty-two patients with newly diagnosed squamous cell carcinoma of the oral cavity, oropharynx, or larynx with at least 2 years of clinical follow-up were included in this study. Quantitative analyses of EF5 immunofluorescence was carried out, and these data were compared with patient outcome. Results: EF5 immunostaining showed substantial intra- and intertumoral hypoxic heterogeneity. The majority of cells in all tumors were well oxygenated. Three patterns of EF5 binding in cells were identified using criteria based on the cellular region that was stained (peripheral or central) and the relationship of binding to necrosis. We tested the association between EF5-binding levels with event-free and overall survival irrespective of the pattern of cellular binding or treatment regimen. Patients with tumors containing EF5-binding regions corresponding to severe hypoxia ({<=}0.1% oxygen) had a shorter event-free survival time than patients with pO{sub 2} values greater than 0.1% (p = 0.032). Nodal status was also predictive for outcome. Conclusions: These data illustrate the potential utility of EF5 binding based on quantitative immunohistochemistry of tissue pO{sub 2} and provide support for the development of noninvasive hypoxia positron emission tomographic studies with fluorine 18-labeled EF5.

• OSTI ID: 21039612
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 4 Vol. 69; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ANOXIA
CARCINOMAS
FLUORINE 18
HEAD
LARYNX
NECK
NECROSIS
ORAL CAVITY
OXYGEN
PATIENTS
POSITRONS
SURVIVAL TIME