• Int. J. Radiat. Oncol. Biol. Phys. · Aug 2012

    Randomized Controlled Trial Multicenter Study

    Monitoring of circulating tumor cells and their expression of EGFR/phospho-EGFR during combined radiotherapy regimens in locally advanced squamous cell carcinoma of the head and neck.

    • Ingeborg Tinhofer, Tsvetana Hristozova, Carmen Stromberger, Ulrich Keilhoiz, and Volker Budach.
    • Translational Radiooncology Laboratory, Department of Radiooncology and Radiotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany. ingeborg.tinhofer@charite.de
    • Int. J. Radiat. Oncol. Biol. Phys. 2012 Aug 1;83(5):e685-90.

    PurposeThe numbers of circulating tumor cells (CTCs) and their expression/activation of epidermal growth factor receptor (EGFR) during the course of combined chemo- or bioradiotherapy regimens as potential biomarkers of treatment efficacy in squamous cell carcinoma of the head and neck (SCCHN) were determined.Methods And MaterialsPeripheral blood samples from SCCHN patients with locally advanced stage IVA/B disease who were treated with concurrent radiochemotherapy or induction chemotherapy followed by bioradiation with cetuximab were included in this study. Using flow cytometry, the absolute number of CTCs per defined blood volume as well as their expression of EGFR and its phosphorylated form (pEGFR) during the course of treatment were assessed.ResultsBefore treatment, we detected ≥1 CTC per 3.75 mL blood in 9 of 31 patients (29%). Basal expression of EGFR was detected in 100% and pEGFR in 55% of the CTC+ cases. The frequency of CTC detection was not influenced by induction chemotherapy. However, the number of CTC+ samples significantly increased after radiotherapy. This radiation-induced increase in CTC numbers was less pronounced when radiotherapy was combined with cetuximab compared to its combination with cisplatin/5-fluorouracil. The former treatment regimen was also more effective in reducing pEGFR expression in CTCs.ConclusionsDefinitive radiotherapy regimens of locally advanced SCCHN can increase the number of CTCs and might thus contribute to a systemic spread of tumor cells. Further studies are needed to evaluate the predictive value of the radiation-induced increase in CTC numbers and the persistent activation of the EGFR signalling pathway in individual CTC+ cases.Copyright © 2012 Elsevier Inc. All rights reserved.

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