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To evaluate immunoexpression of epidermal growth factor receptor (EGFR), phosphorylated EGFR (pEGFRTyr1068), and cyclooxygenase-2 (COX-2) and analyze their prognostic utility in nasopharyngeal carcinomas (NPC).We used a retrospective review of charts and tissue specimens. The immunoexpression levels of EGFR, pEGFRTyr1068, and COX-2 were semiquantitatively assessed by the H-score method for 170 NPC samples from patients treated with radiotherapy (RT) alone.The ranges of immunohistochemical H-scores were 0-510 (median 225) for EGFR, 0-395 (median 25) for pEGFRTyr1068, and 0-460 (median 170) for COX-2. None of these 3 markers were significantly associated with one another, clinicopathological factors, or the rates of locoregional control (LRC), distant metastasis-free survival (DMFS), or overall survival (OS). In multivariate analysis, the independent adverse prognosticators were T-stage for LRC, N-stage for DMFS, and T-stage, N-stage, and age60 years for OS.Immunoexpression levels of EGFR, pEGFRTyr1068, and COX-2 were not related to clinicopathological variables and not predictive of outcomes of NPC patients treated with RT alone.

The aim of this study was to investigate the impact of comorbidity on survival for patients with locally advanced head and neck squamous cell carcinoma (HNSCC).A total of 214 patients with locally advanced HNSCC, treated with radiotherapy (RT) or RT plus chemotherapy (CT) from January 2000 to December 2003, were included. Comorbidity was scored by the Charlson comorbidity index (CCI). The patient-, tumor-, and treatment-related variables were recorded and overall survival (OS) and disease specific survival (DSS) were calculated.Seventy-one patients (33%) had at least one comorbid condition. The most common comorbid condition was liver disease (13.6%). Higher CCI scores were not significantly correlated with exposure to smoking, alcohol, or betel quid, but were associated with older age, fewer years of education years, and no CT (p0.05). The 3-year OS and DSS rates were, respectively, 21.9% and 24.4% for all patients; 25.9% and 26.9% for those with CCI scores of 0, 21.8% and 28.3% for scores of 1, and 3.5% and 7.5% for scoresor=2. Multivariate analysis revealed that a CCI scoreor=2, stage IV disease, a RT dose70 Gy, and no CT were significant predictors of poorer OS and DSS.Our data reveal the significant survival impact of comorbidity on patients with locally advanced HNSCC treated by RT or RT plus CT.

To review the biologic behavior, therapy and natural courses of patients with extrapulmonary small cell carcinoma (EPSCC) in a medical center.We used the computer assisted search for patients diagnosed with EPSCC registered from July 1986 through April 2005. The eligible patients had pathologically proven SCC in sites other than the lung and normal chest radiographs, computed tomography of the chest, sputum cytology, and/or negative bronchoscopic findings.Twenty patients with EPSCC were identified and 12 patients (60%) had limited disease (LD). For the patients with LD receiving systemic chemotherapy, the response rate was 73% (36.5% complete response (CR), 36.5% partial response (PR). However, most of the patients experienced rapid systemic recurrence, with a median disease free survival (DFS) of 8 months. Patients with extensive disease (ED) received mostly etoposide-cisplatin (EP) based chemotherapy, for which the response rate was 50%. The median overall survival (OS) of the patients with LD and ED was 22 months and 3 months. The patients with EPSCC of the head and neck region showed a favorable clinical course, with a median OS of 43 months. Patients with EPSCC of sites other than the head and neck region had aggressive courses with a median OS of 15.5 months.Integrated chemoradiotherapy with surgery for patients with LD generates realistic survival results. EP-based chemotherapy should be the current chemotherapy regimen of choice for patients with ED. Patients with EPSCC of sites other than the head and neck region was usually had poor overall outcomes.