The change in circulating tumor cells before and during concurrent chemoradiotherapy is associated with survival in patients with locally advanced head and neck cancer

Hung-Ming Wang; Min-Hsien Wu; Pei-Hung Chang; Hung-Chi Lin; Chun-Da Liao; Sheng-Min Wu; Tsung-Min Hung; Chine-Yu Lin; Tung-Chieh Chang; Yen Tzu-Tsen; Jason Chia-Hsun Hsieh

doi:10.1002/hed.25744

The change in circulating tumor cells before and during concurrent chemoradiotherapy is associated with survival in patients with locally advanced head and neck cancer

Head Neck. 2019 Aug;41(8):2676-2687. doi: 10.1002/hed.25744. Epub 2019 Mar 22.

Authors

Hung-Ming Wang¹, Min-Hsien Wu^{1

2

3}, Pei-Hung Chang^{4

5}, Hung-Chi Lin¹, Chun-Da Liao⁶, Sheng-Min Wu¹, Tsung-Min Hung⁷, Chine-Yu Lin⁷, Tung-Chieh Chang⁷, Yen Tzu-Tsen^{8

9}, Jason Chia-Hsun Hsieh^{1

2}

Affiliations

¹ Circulating Tumor Cell Lab, Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan.
² Graduate Institute of Biomedical Engineering, Chang Gung University, Taoyuan, Taiwan.
³ Department of Chemical Engineering, Ming Chi University of Technology, New Taipei City, Taiwan.
⁴ Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan and Chang Gung University, Taoyuan, Taiwan.
⁵ Cancer Center, Chang Gung Memorial Hospital, Keelung, and Chang Gung University, Taoyuan, Taiwan.
⁶ Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan.
⁷ Department of Radiation Oncology, Chang Gung Memorial Hospital, Linkou, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
⁸ Molecular Imaging Center, Linkou Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan.
⁹ Department of Nuclear Medicine, Linkou Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan, Taiwan.

PMID: 30903634
DOI: 10.1002/hed.25744

Abstract

Background: This study aimed to evaluate the role of baseline circulating tumor cells (CTCs) before and during concurrent chemoradiotherapy and attempted to determine the impacts of CTCs on the outcomes in patients with head and neck squamous cell carcinoma.

Methods: CTCs were detected using a negative selection strategy and flow cytometry protocol.

Results: We observed a significant correlation between baseline CTCs and staging (P = 0.001). The CTC counts were significantly reduced within 2-4 weeks in 47 concurrent chemoradiotherapy responders (P < 0.001). Change of CTC counts correlates with progression-free survival (PFS, P = 0.01) and overall survival (OS, P = 0.01). CTC decline status was an independent prognostic factor in PFS (P = 0.03) and OS (P = 0.05) in multivariate analyses.

Conclusion: In chemoradiotherapy responders, CTCs are significantly reduced. CTC decline within the first month indicates a longer PFS and OS, suggesting that the dynamics of CTCs could be more important than CTC number alone.

Keywords: cancer; circulating tumor cells; concurrent chemoradiotherapy; patients with cancer; survival.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Biomarkers, Tumor / blood
Chemoradiotherapy*
Female
Head and Neck Neoplasms / mortality
Head and Neck Neoplasms / pathology*
Head and Neck Neoplasms / therapy
Humans
Intention to Treat Analysis
Logistic Models
Male
Middle Aged
Neoplastic Cells, Circulating*
Prognosis
Proportional Hazards Models
Squamous Cell Carcinoma of Head and Neck / mortality
Squamous Cell Carcinoma of Head and Neck / pathology*
Squamous Cell Carcinoma of Head and Neck / therapy
Survival Analysis

Substances

Biomarkers, Tumor

Abstract

Publication types

MeSH terms

Substances

Grants and funding