Mutagen Sensitivity as aPredictor of Tumor Recurrence in Patients With Cancer of the Upper Aerodigestive Tract

Extract

Uncontrolled local-regional disease is a serious problem in patients with squamous cell carcinoma of the head and neck (1). Tumor stage and site are currently the major clinical determinants of treatment selection. However, identification of better predictive biologic markers would improve the making of decisions regarding treatment and might lead to intervention strategies that target patients most likely to benefit.

Therefore, we analyzed the data from a series of patients with cancer of the upper aerodigestive tract; these patients were enrolled in an ongoing, multicenter, phase III placebo-controlled trial of 13-cis-retinoic acid for the prevention of second primary tumors. Our purpose was to evaluate the associations among treatment failure (disease recurrence), baseline sociodemographic characteristics, and an in vitro marker of susceptibility, i.e., bleomycin-induced chromosomal sensitivity, which we previously showed is an independent risk factor for cancers of the upper aerodigestive tract (2).

The eligibility criteria for the chemoprevention trial included a confirmed diagnosis of squamous cell carcinoma of the upper aerodigestive tract (oral cavity, pharynx, or larynx), within the previous 3 years, stage I or II disease (according to American Joint Committee Staging criteria), and definitive prior local therapy. Eligible patients were enrolled at The University of Texas M. D. Anderson Cancer Center, Houston, and by the Radiation Therapy Oncology Group and Clinical Community Oncology Program during the period from January 6, 1992, through October 19, 1995. This research was approved by all relevant review boards and in accord with an assurance filed with and approved by the U.S. Department of Health and Human Services. Patient consent forms were obtained.