RESUMEN
BACKGROUND: The prognostic role of circulating tumor cells (CTCs) after induction chemotherapy using docetaxel, cisplatin and fluorouracil (TPF) prior to surgery and adjuvant (chemo)radiation in locally advanced oral squamous cell cancer (OSCC) was evaluated. METHODS: In this prospective study, peripheral blood samples from 40 patients of the phase II study TISOC-1 (NCT01108042) with OSCC before, during, and after treatment were taken. CTCs were quantified using laser scanning cytometry of anti- epithelial cell adhesion molecule-stained epithelial cells. Their detection was correlated with clinical risk factors, recurrence-free (RFS) and overall survival (OS). RESULTS: Before starting the treatment CTCs were detected in 32 of 40 patients (80%). The median number at baseline was 3295 CTCs/ml. The median maximal number of CTCs during treatment was 5005 CTCs/ml. There was a significant increase of CTCs before postoperative radiotherapy compared to baseline before 1st cycle of IC (p = 0.011), 2nd cycle of IC (p = 0.001), 3rd cycle of IC (p = 0.004), and before surgery (p = 0.002), but not compared to end of therapy (p = 0.118). CTCs at baseline >median was also associated to risk of recurrence (p = 0.014). Maximal CTCs during therapy >median was more frequently observed in tumors of the oral cavity (p=0.022) and related to higher risk of death during follow-up (p = 0.028). Patients with CTCs at baseline >median value had significant lower RFS than patients with CTCs at baseline Asunto(s)
Carcinoma de Células Escamosas/terapia
, Quimioterapia de Inducción
, Neoplasias de la Boca/terapia
, Células Neoplásicas Circulantes/patología
, Neoplasias Orofaríngeas/terapia
, Cuidados Posoperatorios
, Carcinoma de Células Escamosas/tratamiento farmacológico
, Carcinoma de Células Escamosas/radioterapia
, Carcinoma de Células Escamosas/cirugía
, Recuento de Células
, Supervivencia sin Enfermedad
, Femenino
, Humanos
, Estimación de Kaplan-Meier
, Masculino
, Persona de Mediana Edad
, Neoplasias de la Boca/tratamiento farmacológico
, Neoplasias de la Boca/radioterapia
, Neoplasias de la Boca/cirugía
, Análisis Multivariante
, Recurrencia Local de Neoplasia/patología
, Estadificación de Neoplasias
, Neoplasias Orofaríngeas/tratamiento farmacológico
, Neoplasias Orofaríngeas/radioterapia
, Neoplasias Orofaríngeas/cirugía
, Pronóstico
, Modelos de Riesgos Proporcionales
, Factores de Riesgo