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High XRCC1 Protein Expression Is Associated with Poorer Survival in Patients with Head and Neck Squamous Cell Carcinoma


Ang, Mei-Kim; Patel, Mihir R.; Yin, Xiao-Ying; Sundaram, Sneha; Fritchie, Karen J.; Zhao, Ni; Liu, Yufeng; Freemerman, Alex J.; Wilkerson, Matthew D.; & Walter, Vonn, et al. (2011). High XRCC1 Protein Expression Is Associated with Poorer Survival in Patients with Head and Neck Squamous Cell Carcinoma. Clinical Cancer Research, 17(20), 6542-6552. PMCID: PMC3725262


PURPOSE: We evaluated X-ray repair complementing defective repair in Chinese hamster cells 1 (XRCC1) protein in head and neck squamous cell carcinoma (HNSCC) patients in association with outcome.
EXPERIMENTAL DESIGN: XRCC1-protein expression was assessed by immunohistochemical (IHC) staining of pre-treatment tissue samples in 138 consecutive HNSCC patients treated with surgery (n=31), radiation (15), surgery and radiation (23), surgery and adjuvant chemoradiation (17), primary chemoradiation (51) and palliative measures (1).
RESULTS: Patients with high XRCC1-expression by IHC (n=77) compared to patients with low XRCC1-expression (n=60) had poorer median overall survival (OS) (41.0 months vs. OS not reached, P =0.009) and poorer progression-free survival (28.0 months vs. 73 months, P =0.031). This association was primarily due to patients who received chemoradiation (median OS of high and low XRCC1-expression patients, 35.5 months and not reached respectively, Hazard ratio (HR) 3.48; 95% Confidence interval (CI), 1.44-8.38; P =0.006). In patients treated with non-chemoradiation modalities, there was no survival difference by XRCC1-expression. In multivariable analysis, high XRCC1-expression and p16INK4a-positive status were independently associated with survival in the overall study population (HR 2.62; 95% CI, 1.52-4.52; P <0.001 and HR 0.21; 95% CI 0.06-0.71; P =0.012 respectively) and among chemoradiation patients (HR 6.02; 95% CI 2.36-15.37; P <0.001 and HR 0.26; 95% CI, 0.08-0.92 respectively; P =0.037).
CONCLUSIONS: In HNSCC, high XRCC1-protein expression is associated with poorer survival, particularly in patients receiving chemoradiation. Future validation of these findings may enable identification of HNSCC-expressing patients who benefit from chemoradiation treatment.


Reference Type

Journal Article

Year Published


Journal Title

Clinical Cancer Research


Ang, Mei-Kim
Patel, Mihir R.
Yin, Xiao-Ying
Sundaram, Sneha
Fritchie, Karen J.
Zhao, Ni
Liu, Yufeng
Freemerman, Alex J.
Wilkerson, Matthew D.
Walter, Vonn
Weissler, Mark Christian
Shockley, William W.
Couch, Marion E.
Zanation, Adam M.
Hackman, Trevor G.
Chera, Bhishamjit S.
Harris, Stephen L.
Miller, C. Ryan
Thorne, Leigh B.
Hayward, Michele C.
Funkhouser, William K.
Olshan, Andrew F.
Shores, Carol G.
Makowski, Liza
Hayes, D. Neil