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Int J Radiat Oncol Biol Phys. 2015 May 1;92(1):84-90. doi: 10.1016/j.ijrobp.2014.10.004. Epub 2014 Dec 2.

Radiation therapy overcomes adverse prognostic role of cyclooxygenase-2 expression on Reed-Sternberg cells in early Hodgkin lymphoma.

Author information

1
Service of Radiation Therapy, University Hospital Son Espases, Instituto de Investigación Sanitaria de Palma, Palma de Mallorca, Spain.
2
Service of Hematology, University Hospital Son Espases, Instituto de Investigación Sanitaria de Palma, Palma de Mallorca, Spain. Electronic address: antoniom.gutierrez@ssib.es.
3
MD Anderson Cancer Center, Madrid, Spain.
4
Service of Pathology, University Hospital Son Espases, Instituto de Investigación Sanitaria de Palma, Palma de Mallorca, Spain.
5
Spanish National Cancer Research Centre, Madrid, Spain.
6
Service of Hematology, University Hospital Son Espases, Instituto de Investigación Sanitaria de Palma, Palma de Mallorca, Spain.
7
Service of Radiation Therapy, Policlinica Miramar, Palma de Mallorca, Spain.
8
Service of Radiology, IDISPA, Palma de Mallorca, Spain.
9
Service of Nuclear Medicine, IDISPA, Palma de Mallorca, Spain.

Abstract

PURPOSE:

To analyze the role of radiation therapy (RT) on the adverse prognostic influence of cyclooxygenase-2 (COX-2) expression on Reed-Sternberg (RS) cells, in the setting of early Hodgkin lymphoma (HL) treated with ABVD (adriamycin, vinblastine, bleomycin, dacarbazine).

METHODS AND MATERIALS:

In the present study we retrospectively investigated the prognostic value of COX-2 expression in a large (n=143), uniformly treated early HL population from the Spanish Network of HL using tissue microarrays. Univariate and multivariate analyses were done, including the most recognized clinical variables and the potential role of administration of adjuvant RT.

RESULTS:

Median age was 31 years; the expression of COX-2 defined a subgroup with significantly worse prognosis. Considering COX-2(+) patients, those who received RT had significantly better 5-year progression-free survival (PFS) (80% vs 54% if no RT; P=.008). In contrast, COX-2(-) patients only had a modest, nonsignificant benefit from RT in terms of 5-year PFS (90% vs 79%; P=.13). When we compared the outcome of patients receiving RT considering the expression of COX-2 on RS cells, we found a nonsignificant 10% difference in terms of PFS between COX-2(+) and COX-2(-) patients (P=.09), whereas the difference between the 2 groups was important (25%) in patients not receiving RT (P=.04).

CONCLUSIONS:

Cyclooxygenase-2 RS cell expression is an adverse independent prognostic factor in early HL. Radiation therapy overcomes the worse prognosis associated with COX-2 expression on RS cells, acting in a chemotherapy-independent way. Cyclooxygenase-2 RS cell expression may be useful for determining patient candidates with early HL to receive consolidation with RT.

PMID:
25475251
DOI:
10.1016/j.ijrobp.2014.10.004
[Indexed for MEDLINE]
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