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. 2014 Jan 21;110(2):501-9.
doi: 10.1038/bjc.2013.640. Epub 2013 Oct 15.

Tumour-infiltrating lymphocytes predict response to definitive chemoradiotherapy in head and neck cancer

P Balermpas  1 , Y Michel  2 , J Wagenblast, O Seitz  3 , C Weiss  1 , F Rödel  1 , C Rödel  1 , E Fokas  1
Affiliations

Tumour-infiltrating lymphocytes predict response to definitive chemoradiotherapy in head and neck cancer

P Balermpas et al. Br J Cancer. .

Erratum in

  • Br J Cancer. 2014 Jan 21;110(2):547

Abstract

Background: We aimed to investigate the prognostic value of tumour-infiltrating lymphocytes' (TILs) expression in pretreatment specimens from patients with head and neck squamous cell carcinoma (HNSCC) treated with definitive chemoradiotherapy (CRT).

Methods: The prevalence of CD3+, CD8+, CD4+ and FOXP3+ TILs was assessed using immunohistochemistry in tumour tissue obtained from 101 patients before CRT and was correlated with clinicopathological characteristics as well as local failure-free- (LFFS), distant metastases free- (DMFS), progression-free (PFS) and overall survival (OS). Survival curves were measured using the Kaplan-Meier method, and differences in survival between the groups were estimated using the log-rank test. Prognostic effects of TIL subset density were determined using the Cox regression analysis.

Results: With a mean follow-up of 25 months (range, 2.3-63 months), OS at 2 years was 57.4% for the entire cohort. Patients with high immunohistochemical CD3 and CD8 expression had significantly increased OS (P=0.024 and P=0.028), PFS (P=0.044 and P=0.047) and DMFS (P=0.021 and P=0.026) but not LFFS (P=0.90 and P=0.104) in multivariate analysis that included predictive clinicopathologic factors, such as age, sex, T-stage, N-stage, tumour grading and localisation. Neither CD4 nor FOXP3 expression showed significance for the clinical outcome. The lower N-stage was associated with improved OS in the multivariate analysis (P=0.049).

Conclusion: The positive correlation between a high number of infiltrating CD3+ and CD8+ cells and clinical outcome indicates that TILs may have a beneficial role in HNSCC patients and may serve as a biomarker to identify patients likely to benefit from definitive CRT.

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Figures

Figure 1
Figure 1
Prognostic role of CD3 and CD8 in the outcome of patients with head and neck squamous cell carcinoma after definitive chemoradiotherapy. (A) OS; (B) PFS; (C) LFFS; (D) and DMFS according to pretreatment CD3 and CD8 expression (low CD3 and CD8 expression: weighted score ⩽6; high CD3 and CD8 expression: weighted score >6; the cutoff score was based on the median value).
Figure 2
Figure 2
Representative examples of low and high CD3 and CD8 expression in head and neck squamous cell carcinoma samples, as indicated. Magnification, × 1.
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