Vascular endothelial growth factor independently predicts the efficacy of postoperative radiotherapy in node-negative breast cancer patients
| Autor: | Peggy, Manders, Fred C G J, Sweep, Vivianne C G, Tjan-Heijnen, Anneke, Geurts-Moespot, Doorléne T H, van Tienoven, John A, Foekens, Paul N, Span, Jan, Bussink, Louk V A M, Beex |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Vascular Endothelial Growth Factor A Time Factors Neovascularization Pathologic Breast Neoplasms Enzyme-Linked Immunosorbent Assay Middle Aged Prognosis Disease-Free Survival Up-Regulation Treatment Outcome Lymphatic Metastasis Multivariate Analysis Humans Lymph Nodes Neoplasm Metastasis Hypoxia Aged Proportional Hazards Models |
| Zdroj: | Clinical cancer research : an official journal of the American Association for Cancer Research. 9(17) |
| ISSN: | 1078-0432 |
| Popis: | Vascular endothelial growth factor (VEGF) is a mediator of angiogenesis and is up-regulated under hypoxic conditions. Hypoxic tumors are known to exhibit resistance to radiotherapy. We investigated the association between VEGF levels in tumor tissue and the effect of radiotherapy for relapse-free survival (RFS) and overall survival (OS) in node-negative breast cancer.The study was performed on 489 patients; 221 patients received postoperative radiotherapy as part of the breast-conserving therapy (BCT), and 268 patients were treated by mastectomy only. VEGF levels were measured using a quantitative ELISA. None of the patients received adjuvant systemic therapy. The median follow-up was 64 months (range, 2-149) after BCT and 59 months (range, 2-117) after mastectomy. Correlations with well-known prognostic factors were studied, and univariate and multivariate survival analyses were performed.Only in the BCT group, high VEGF levels (equal or above the median level) predicted a reduced RFS and OS in univariate survival analysis (P = 0.004 and P = 0.028, respectively), implying that patients with high VEGF levels have less benefit from BCT. This was seen as a significant interaction between local treatment and VEGF for the total population for RFS (P = 0.012) and OS (P = 0.004). The interaction between local treatment and tumor size was also significant for both RFS (P = 0.046) and OS (P = 0.019) in the multivariate analysis.These results show that, in node-negative patients, both tumor size and VEGF content predict for a reduced efficacy of postoperative radiotherapy as part of BCT, indicating that the choice of local treatment of these patients can also be modified based on tumor VEGF content. |
| Databáze: | OpenAIRE |
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