A Novel In Vivo Protocol for Molecular Study of Radiation-Induced Fibrosis in Head and Neck Cancer Patients

Ann Otol Rhinol Laryngol. 2016 Mar;125(3):228-34. doi: 10.1177/0003489415607527. Epub 2015 Oct 8.

Abstract

Objectives: Radiation-induced fibrosis is a common complication for patients following head and neck cancer treatment. This study presents a novel minimally invasive protocol for molecular study of fibrosis in the stromal tissues.

Methods: Subjects with radiation-induced fibrosis in the head and neck who were at least 6 months post treatment received submental core needle biopsies, followed by molecular processing and quantification of gene expression for 14 select pro-inflammatory and pro-fibrotic genes. Control biopsies from the upper arm were obtained from the same subjects. Patients were followed up at 1 and 2 weeks to monitor for safety and adverse outcomes.

Results: Six subjects were enrolled and completed the study. No subjects experienced adverse outcomes or complication. An 18 gauge core biopsy needle with a 10 mm notch inserted for up to 60 seconds was needed. Subcutaneous tissue yielded 3 ng of RNA, amplified to 6 µg of cDNA, allowing for adequately sensitive quantitative polymerase chain reaction (qPCR) analysis of approximately 28 genes.

Conclusions: This study demonstrates the safety and utility of a novel technique for the molecular study of fibrosis in head and neck cancer patients. Longitudinal studies of patients undergoing radiation therapy will allow for identification of molecular targets that contribute to the process of fibrosis in the head and neck.

Keywords: biopsy; clinical protocols; fibrosis; head and neck neoplasms; radiation effects.

MeSH terms

  • Aged
  • Biopsy / adverse effects
  • Biopsy / methods*
  • Carcinoma, Squamous Cell / radiotherapy*
  • Clinical Protocols
  • Connective Tissue / pathology*
  • Feasibility Studies
  • Female
  • Fibrosis / etiology
  • Gene Expression
  • Head and Neck Neoplasms / radiotherapy*
  • Humans
  • Male
  • Middle Aged
  • Neck / pathology*
  • RNA, Messenger / genetics
  • Radiation Injuries / pathology*
  • Radiotherapy / adverse effects
  • Reverse Transcriptase Polymerase Chain Reaction

Substances

  • RNA, Messenger