Hypoxia Inducible Factor-1α and Vascular Endothelial Growth Factor Expression are Associated with a Poor Prognosis in Patients with Nasopharyngeal Carcinoma Receiving Radiotherapy with Carbogen and Nicotinamide

Xueguan, Lu; Xiaoshen, Wang; Yongsheng, Zhang; Chaosu, Hu; Chunying, Shen; Yan, Feng

doi:10.1016/j.clon.2008.07.001

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Volume 20, Issue 8 , Pages 606-612, October 2008

Hypoxia Inducible Factor-1α and Vascular Endothelial Growth Factor Expression are Associated with a Poor Prognosis in Patients with Nasopharyngeal Carcinoma Receiving Radiotherapy with Carbogen and Nicotinamide

Lu Xueguan
- Department of Radiation Oncology, Second Affiliated Hospital of Soochow University, Suzhou, China
- Department of Radiation Oncology, Cancer Hospital of Fudan University, Shanghai, China
- Author for correspondence: Xueguan Lu, Department of Radiation Oncology, Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou 215004, Jiangsu Province, China. Tel: +86-512-67783916; Fax: +86-512-68284303.
Wang Xiaoshen
- Department of Radiation Oncology, Cancer Hospital of Fudan University, Shanghai, China
Zhang Yongsheng
- Department of Pathology, Second Affiliated Hospital of Soochow University, Suzhou, China
Hu Chaosu
- Department of Radiation Oncology, Cancer Hospital of Fudan University, Shanghai, China
Shen Chunying
- Department of Radiation Oncology, Cancer Hospital of Fudan University, Shanghai, China
Feng Yan
- Department of Radiation Oncology, Cancer Hospital of Fudan University, Shanghai, China

Received 7 March 2008; received in revised form 2 July 2008; accepted 3 July 2008.

Abstract

Aims

Hypoxia reduces tumour radiosensitivity and hypoxia inducible factor-1α (HIF-1α) plays an important role in this process. The aim of the study was to assess the prognostic impact of HIF-1α and vascular endothelial growth factor (VEGF) in patients with nasopharyngeal carcinoma who received radiation with hypoxia-modifying therapy (carbogen plus nicotinamide).

Materials and methods

The immunohistochemical expression of HIF-1α and VEGF was evaluated in nasopharyngeal carcinoma biopsies from 59 patients who received conventional radiotherapy combined with carbogen and nicotinamide.

Results

A significant positive association was found between HIF-1α and VEGF expression (P=0.003). There was no association found between the level of HIF-1α, VEGF expression and tumour stage, nodal stage, or clinical stage. Kaplan–Meier plots showed that positive HIF-1α and VEGF expression were associated with a higher distant metastasis, a worse overall and disease-free survival, and the level of HIF-1α and VEGF expression had no effect on locoregional recurrence. The multivariate analysis failed to confirm any association between HIF-1α or VEGF and metastasis, disease-free or overall survival.

Conclusions

These results suggest that the expression of hypoxia-associated markers (HIF-1α and VEGF) may have prognostic significance in patients with nasopharyngeal carcinoma who receive radiation plus carbogen and nicotinamide, but further study is needed.

Key words: Hypoxia inducible factor-1α, nasopharyngeal carcinoma, prognosis, radiotherapy, vascular endothelial growth factor