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J Korean Soc Ther Radiol Oncol > Volume 25(3); 2007 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2007;25(3): 145-150.
Impact of Cyclooxygenase-2 Expression on the Survival of Glioblastoma
Youngmin Choi, Dae Cheol Kim, Ki Uk Kim, Young Jin Song, Hyung Sik Lee, Won Joo Hur, Sun Seob Choi, Su Yeong Seo
1Department of Radiation Oncology, Dong-A University School of Medicine, Busan, Korea. cymin00@dau.ac.kr
2Department of Pathology, Dong-A University School of Medicine, Busan, Korea.
3Department of Neurosurgery, Dong-A University School of Medicine, Busan, Korea.
4Department of Diagnostic Radiology, Dong-A University School of Medicine, Busan, Korea.
5Department of Microbiology, Dong-A University School of Medicine, Busan, Korea.
ABSTRACT
PURPOSE:
To investigate the degree and effect of cyclooxygenase (COX)-2 expression on the survival of patients with glioblastoma multiforme (GM).
MATERIALS AND METHODS:
Between 1997 and 2006, thirty consecutive GM patients treated with surgery and postoperative radiotherapy (dose range: 44~65.1 Gy, median dose: 61.2 Gy) were included in the study. Three patients were excluded that discontinued radiotherapy before receiving a dose of 40 Gy due to mental deterioration. The expression of the COX-2 protein in surgical specimens was examined by immunohistochemical analysis. Survival analysis and verification were performed with respect to sex, age, performance status, resection extent, radiotherapy dose, and degree of COX-2 expression using the Kaplan-Meier method and the log rank test.
RESULTS:
The median length of follow-up was 13.3 months (range: 6~83 months). Staining for COX-2 was positive in all patient samples. Staining for COX-2 that was positive for over 75% of the tumor cells was found in 24 patients. Staining for COX-2 that was positive in less than 25% of tumor cells was found in 3 patients (10.0%), staining for COX-2 that was positive in 25 to 50% of tumor cells was found in 1 patient (3.3%), staining for COX-2 that was positive in 50 to 75% of tumor cells was found in 2 patients (6.7%) and staining for COX-2 that was positive in 75 to 100% of tumor cells was found in 24 patients (80.0%). The median survival and two-year survival rate were 13.5 months and 17.5%, respectively. The survival rate was influenced significantly by the degree of resection (tumor removal by 50% or more) and radiotherapy dose (59 Gy or greater) (p<0.05). The median survival of patients with staining for COX-2 that was positive in less than 75% of tumor cells and in at least 75% of tumor cells was 15.5 and 13.0 months, respectively (p>0.05), and the two-year survival for these groups was 33.3 and 13.3%, respectively (p>0.05).
CONCLUSION:
The absence of a statistical correlation between the degree of COX-2 expression and survival in GM patients, despite the high rate of COX-2 positive tumor cells in the GM patient samples, requires further studies with a larger series to ascertain the prognostic value of the degree of COX-2 expression in GM patients.
Key Words: Glioblastoma, Cyclooxygenase-2, Radiotherapy, Survival
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