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document
Pre-treatment proliferation and the outcome of conventional and accelerated radiotherapy . This study investigated the influence of pre-treatment proliferation characteristics , assessed by Ki-67 staining , in patients treated in the CHART trial of accelerated radiotherapy in head and neck cancer . Histological material from 402 patients was collected and stained for the presence and pattern of Ki-67 staining . Locoregional control and overall survival were the main clinical endpoints . Increasing Ki-67 positivity was associated with decreasing differentiation ( P < 0.001 ) and increasing N-stage ( P < 0.004 ) . Increasing N-stage was also associated with the progression of proliferation pattern from marginal to random ( P < 0.001 ) . Using a multivariate model , a trend was seen towards a greater benefit from CHART in the lower Ki-67 tumours ( P = 0.08 ) ; this became significant by pooling the low and intermediate Ki-67 groups in comparison with the high Ki-67 group ( P = 0.032 ) . Tumours with marginal proliferation pattern showed a lower hazard ratio with CHART versus conventional for locoregional control ( P = 0.005 ) . The data presented in this study do not support that a high pre-treatment Ki-67 is associated with a therapeutic benefit from accelerated radiotherapy .
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Intervention_Physical
conventional and accelerated radiotherapy
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Intervention_Physical
assessed by Ki-67 staining
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Intervention_Physical
accelerated radiotherapy
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Intervention_Physical
accelerated radiotherapy
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Outcome_Physical
Locoregional control
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Outcome_Other
therapeutic benefit