Weak expression of cyclooxygenase-2 is associated with poorer outcome in endemic nasopharyngeal carcinoma: analysis of data from randomized trial between radiation alone versus concurrent chemo-radiation (SQNP-01)

• Published in: Radiation oncology (London, England) England), 2009-07, Vol.4 (1), p.23-23, Article 23
• Main Authors: Loong, Susan Li Er, Hwang, Jacqueline Siok Gek, Li, Hui Hua, Wee, Joseph Tien Seng, Yap, Swee Peng, Chua, Melvin Lee Kiang, Fong, Kam Weng, Tan, Terence Wee Kiat
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Care and treatment; Clinical Trials, Phase III as Topic; Combined Modality Therapy; Cyclooxygenase 2 - metabolism; Cyclooxygenases; Diagnosis; Female; Health aspects; Humans; Male; Middle Aged; Nasopharyngeal cancer; Nasopharyngeal Neoplasms - drug therapy; Nasopharyngeal Neoplasms - enzymology; Nasopharyngeal Neoplasms - radiotherapy; Neoplasm Staging; Patient outcomes; Physiological aspects; Prognosis; Radiotherapy; Radiotherapy Dosage; Randomized Controlled Trials as Topic; Risk factors; Survival Rate; Treatment Outcome; Young Adult
• ISSN: 1748-717X; 1748-717X
• DOI: 10.1186/1748-717X-4-23

Over-expression of cyclooxygenase-2 (COX-2) enzyme has been reported in nasopharyngeal carcinoma (NPC). However, the prognostic significance of this has yet to be conclusively determined. Thus, from our randomized trial of radiation versus concurrent chemoradiation in endemic NPC, we analyzed a cohort of tumour samples collected from participants from one referral hospital. 58 out of 88 patients from this institution had samples available for analysis. COX-2 expression levels were stratified by immunohistochemistry, into negligible, weak, moderate and strong, and correlated with overall and disease specific survivals. 58% had negligible or weak COX-2 expression, while 14% and 28% had moderate and strong expression respectively. Weak COX-2 expression conferred a poorer median overall survival, 1.3 years for weak versus 6.3 years for negligible, 7.8 years, strong and not reached for moderate. There was a similar trend for disease specific survival. Contrary to literature published on other malignancies, our findings seemed to indicate that over-expression of COX-2 confer a better prognosis in patients with endemic NPC. Larger studies are required to conclusively determine the significance of COX-2 expression in these patients.