Abstract
BackgroundThis study was to evaluate the effect of excision repair cross-complementation group 1(ERCC1) expression on response to cisplatin-based induction chemotherapy (IC) followed by concurrent chemoradiation (CCRT) in locally advanced unresectable head and neck squamous cell carcinoma (HNSCC) patients.MethodsFifty-seven patients with locally advanced unresectable HNSCC who received cisplatin-based IC followed by CCRT from January 1, 2006 through January 1, 2008. Eligibility criteria included presence of biopsy-proven HNSCC without a prior history of chemotherapy or radiotherapy. Immunohistochemistry was used to assess ERCC1 expression in pretreatment biopsy specimens from paraffin blocks. Clinical parameters, including smoking, alcohol consumption and betel nuts chewing, were obtained from the medical records.ResultsThe 12-month progression-free survival (PFS) and 2-year overall survival (OS) rates of fifty-seven patients were 61.1% and 61.0%, respectively. Among these patients, thirty-one patients had low ERCC1 expression and forty-one patients responded to IC followed by CCRT. Univariate analyses showed that patients with low expression of ERCC1 had a significantly higher 12-month PFS rates (73.3% vs. 42.3%, p < 0.001) and 2-year OS (74.2 vs. 44.4%, p = 0.023) rates. Multivariate analysis showed that for patients who did not chew betel nuts and had low expression of ERCC1 were independent predictors for prolonged survival.ConclusionsOur study suggest that a high expression of ERCC1 predict a poor response and survival to cisplatin-based IC followed by CCRT in patients with locally advanced unresectable HNSCC in betel nut chewing area.
Highlights
This study was to evaluate the effect of excision repair cross-complementation group 1(ERCC1) expression on response to cisplatin-based induction chemotherapy (IC) followed by concurrent chemoradiation (CCRT) in locally advanced unresectable head and neck squamous cell carcinoma (HNSCC) patients
Patients with locally advanced HNSCC receive surgery and radiotherapy, less than 30% will be cured, and locoregional recurrences or distant metastases develop in 40% to 60% patients [7,8], which occurs with a median survival rate of no more than 6 months [9]
The Meta-Analysis of Chemotherapy in Head and Neck Cancer (MACH-NC) study showed that concomitant chemoradiation is superior to RT alone for patients with advanced HNSCC and chemoradiotherapy has become the standard of care for patients with unresectable
Summary
This study was to evaluate the effect of excision repair cross-complementation group 1(ERCC1) expression on response to cisplatin-based induction chemotherapy (IC) followed by concurrent chemoradiation (CCRT) in locally advanced unresectable head and neck squamous cell carcinoma (HNSCC) patients. Squamous cell carcinoma of the head and neck (HNSCC) is the sixth most common cancer in the world [1] and two-thirds of these patients initially present with locally advanced disease [2]. The Meta-Analysis of Chemotherapy in Head and Neck Cancer (MACH-NC) study showed that concomitant chemoradiation is superior to RT alone for patients with advanced HNSCC and chemoradiotherapy (radiotherapy plus concurrent chemotherapy) has become the standard of care for patients with unresectable
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