Because the apoptotic process appears to be involved in the response-to-treatment of chemotherapy and radiotherapy, we investigated the prognostic value of the expression of three apoptosis-associated genes (p53, Bax, and Bcl-2) in tumor biopsies from patients with locally advanced head and neck carcinoma. Using specific monoclonal antibodies, immunohistochemical staining for p53, Bax, and Bcl-2 was performed on tumor material from 43 patients before their scheduled adjuvant chemoradiotherapy. Results indicated that the response to treatment was 83.7% (36 of 43 patients). Bax staining was positive in 8 cases (19.5%), p53 in 19 (47.5%), and Bcl-2 in 4 patients (10.8%). There were no statistically significant correlations between any of the apoptosis genes assayed and the patients' response to treatment or to overall survival. In the univariate statistical analysis, response-to-treatment was the only significant variable (p = 0.013) predictive of survival rate. These results suggest that p53, Bax, and Bcl-2 expression are not significant predictive factors of response to induction treatment in locally advanced head and neck carcinoma and that their routine use as prognostic markers cannot be recommended.
From the Department of Medical Oncology, Hospital Txagorritxu-Vitoria (S.C., S.D., M.T.A., I.P., I.I., J.M.d.C.), Vitoria-Gasteiz; and Department of Pathology, University Hospital Santiago de Compostela (J.F., R.L.), Santiago de Compostela, Spain.
Address correspondence and reprint requests to Dr. Susana Casado, Dept. Oncología, Hospital Txagorritxu, C/J. Achótegui s/n, 1009 Vitoria-Gasteiz, Spain.