The Journal of Laryngology & Otology

Main Articles

Use of multiple biological markers in radiotherapy-treated head and neck cancer

P Silvaa1a2a6, N J Slevina3, P Sloana5, H Valentinea1, D Rydera4, P Pricea1, C M L Westa1 c1 and J J Homera1a2a6

a1 School of Cancer & Enabling Sciences, The University of Manchester, Manchester, UK

a2 Department of Surgery, Christie Hospital NHS Trust, Manchester, UK

a3 Department of Clinical Oncology, Christie Hospital NHS Trust, Manchester, UK

a4 Department of Medical Statistics, Christie Hospital NHS Trust, Manchester, UK

a5 Department of Pathology, Manchester, UK

a6 Department of Otolaryngology-Head and Neck Surgery, Manchester, UK


Objective: Management of patients with head and neck squamous cell carcinoma is often based on clinical parameters, with little appreciation of the underlying tumour biology. Single biological marker studies fail to acknowledge the complexity of these tumours. Our aim was to define a profile of biological markers associated with outcome.

Design: This retrospective study involved consecutive patients with oropharyngeal squamous cell carcinoma treated with primary radiotherapy between 1996 and 2001. Pre-treatment biopsies were used to study the immunohistochemical expression of nine biological markers. Markers were chosen to reflect biologically relevant pathways.

Results: Following analysis of nine markers, a profile of two markers was derived (carbonic anhydrase 9 and major vault protein), the co-expression of which conferred a significantly poor probability of locoregional control. The prognostic effect of these biomarkers in combination was greater than their effect individually.

Conclusion: Biomarker profiles can be established which highlight large differences in locoregional control. Identifying tumours that express both carbonic anhydrase 9 and major vault protein may facilitate patient selection for more aggressive treatment.

(Accepted November 13 2009)

(Online publication April 14 2010)


c1 Address for correspondence: Prof Catharine West, Translational Radiobiology Group, School of Cancer and Enabling Sciences, The University of Manchester, Christie Hospital, Manchester M20 4BX, UK. Fax: +44 161 446 8111 E-mail:


Presented at the 7th International Conference on Head and Neck Cancer, 22 July 2008, San Francisco, California, USA.

Mr Jarrod Homer and Prof Catharine West takes responsibility for the integrity of the content of the paper.

Competing interests: None declared