Circulating M-MDSC Levels as an Assessment Marker for Post-Treatment Tumor Progression in Recurrent HNC Patients Following Radiation Therapy: A Case Series

Author:

Chang Chun-Hsiang1,Chen Fang-Hsin2ORCID,Wang Ling-Wei34,Chiang Chi-Shiun125ORCID

Affiliation:

1. Department of Biomedical Engineering and Environment Sciences, National Tsing Hua University, Hsinchu 300044, Taiwan

2. Institute of Nuclear Engineering and Science, National Tsing Hua University, Hsinchu 300044, Taiwan

3. Department of Heavy Ion and Radiation Oncology, Taipei Veterans General Hospital, Taipei 112304, Taiwan

4. School of Medicine, National Yang-Ming Chiao Tung University, Taipei 30010, Taiwan

5. Boron Neutron Capture Therapy Center, National Tsing Hua University, Hsinchu 300044, Taiwan

Abstract

Background: In advanced head and neck cancer (HNC) patients, 50–60% experience loco-regional relapse and distant metastasis. Boron neutron capture therapy (BNCT) has shown remarkable therapeutic response in recurrent HNC, but there is still a 70% chance of local recurrence. This study aimed to identify a suitable liquid biomarker to assess patient response following BNCT. Myeloid-derived suppressor cells (MDSCs) are immune-suppressive cells that inhibit cytotoxic T cells. Circulating MDSC levels have been linked to the clinical stage and prognosis in HNSCC. Methods: Five patients with recurrent head and neck cancer underwent a treatment regimen that commenced with BNCT, followed by fractionated image-guided intensity-modulated radiotherapy (IG-IMRT). Liquid biopsy analysis via flow cytometry and tumor volume analysis by clinical imaging were conducted at three stages: before BNCT, before the first fraction of IG-IMRT, and one month after the last fraction of IG-IMRT. Results: Compared to other MDSC subtypes, monocytic MDSCs (M-MDSCs) exhibited a notable correlation with tumor volume. This strong correlation was observed at all testing time points except one month after BNCT treatment. Conclusions: This case series highlights a strong link between tumor size and circulating M-MDSC levels before BNCT and one month after the last IG-IMRT treatment in recurrent head and neck cancer patients. These results suggest that the level of circulating M-MDSCs could be a marker for monitoring tumor progression in recurrent HNC patients following radiation therapy, including BNCT.

Publisher

MDPI AG

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