Radiation Therapy Overcomes Adverse Prognostic Role of Cyclooxygenase-2 Expression on Reed-Sternberg Cells in Early Hodgkin Lymphoma

Journal Article · Fri May 01 00:00:00 EDT 2015 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2014.10.004· OSTI ID:22458697

Mestre, Francisco ^[1]; Gutiérrez, Antonio ^[2]; Rodriguez, Jose ^[3]; Ramos, Rafael ^[4]; Garcia, Juan Fernando ^[5]; Martinez-Serra, Jordi ^[2]; Casasus, Marta; Nicolau, Cristina ^[6]; Bento, Leyre; Herraez, Ines ^[2]; Lopez-Perezagua, Paloma ^[7]; Daumal, Jaime ^[8]; Besalduch, Joan ^[2]

---

1. Service of Radiation Therapy, University Hospital Son Espases, Instituto de Investigación Sanitaria de Palma, Palma de Mallorca (Spain)
2. Service of Hematology, University Hospital Son Espases, Instituto de Investigación Sanitaria de Palma, Palma de Mallorca (Spain)
3. MD Anderson Cancer Center, Madrid (Spain)
4. Service of Pathology, University Hospital Son Espases, Instituto de Investigación Sanitaria de Palma, Palma de Mallorca (Spain)
5. Spanish National Cancer Research Centre, Madrid (Spain)
6. Service of Radiation Therapy, Policlinica Miramar, Palma de Mallorca (Spain)
7. Service of Radiology, IDISPA, Palma de Mallorca (Spain)
8. Service of Nuclear Medicine, IDISPA, Palma de Mallorca (Spain)

Purpose: To analyze the role of radiation therapy (RT) on the adverse prognostic influence of cyclooxygenase-2 (COX-2) expression on Reed-Sternberg (RS) cells, in the setting of early Hodgkin lymphoma (HL) treated with ABVD (adriamycin, vinblastine, bleomycin, dacarbazine). Methods and Materials: In the present study we retrospectively investigated the prognostic value of COX-2 expression in a large (n=143), uniformly treated early HL population from the Spanish Network of HL using tissue microarrays. Univariate and multivariate analyses were done, including the most recognized clinical variables and the potential role of administration of adjuvant RT. Results: Median age was 31 years; the expression of COX-2 defined a subgroup with significantly worse prognosis. Considering COX-2{sup +} patients, those who received RT had significantly better 5-year progression-free survival (PFS) (80% vs 54% if no RT; P=.008). In contrast, COX-2{sup −} patients only had a modest, nonsignificant benefit from RT in terms of 5-year PFS (90% vs 79%; P=.13). When we compared the outcome of patients receiving RT considering the expression of COX-2 on RS cells, we found a nonsignificant 10% difference in terms of PFS between COX-2{sup +} and COX-2{sup −} patients (P=.09), whereas the difference between the 2 groups was important (25%) in patients not receiving RT (P=.04). Conclusions: Cyclooxygenase-2 RS cell expression is an adverse independent prognostic factor in early HL. Radiation therapy overcomes the worse prognosis associated with COX-2 expression on RS cells, acting in a chemotherapy-independent way. Cyclooxygenase-2 RS cell expression may be useful for determining patient candidates with early HL to receive consolidation with RT.

• OSTI ID: 22458697
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 92, Issue 1; Other Information: Copyright (c) 2015 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BLEOMYCIN
CHEMOTHERAPY
COMPARATIVE EVALUATIONS
DOXORUBICIN
HODGKINS DISEASE
MULTIVARIATE ANALYSIS
PATIENTS
POPULATIONS
RADIOTHERAPY
VINBLASTINE