© 2004 European Society for Medical Oncology
Comments on "Expression of Cox-2 protein in radioresistant laryngeal cancer" (Ann Oncol 2004; 15: 1721)
Cox-2 inhibitors are not routinely used for analgesia in head and neck cancer patients treated with radiotherapy. In vitro and in vivo experiments suggest that Cox-2 inhibitors may improve radiation response in Cox-2 positive tumours [1
] and this would be an exciting area for head and neck cancer research. We did not find a correlation between histological grade (well/moderate/poor differentiation) and Cox-2 expression in our series of T1–2 laryngeal tumours. Our scoring system was designed to be simplistic in order that inter-observer variation may be minimised. Upstream and downstream regulators in the Cox-2 pathway should be investigated and prospective clinical studies will be required to confirm the importance of Cox-2. The failure rate for laryngeal cancer patients with a stage T1–2 tumour treated with radiotherapy is 
10%, which means that multi centre trials will be required, but this is a significant clinical problem in this subset of patients.
Postgraduate Medical Institute of the University of Hull in association with Hull York Medical School, University of Hull, 6 7RX, UK
References
1. Pyo H, Choy H, Amorino GP et al. A selective cyclooxygenase-2 inhibitor, NS-398, enhances the effect of radiation in vitro and in vivo preferentially on the cells that express cyclooxygenase-2. Clin Cancer Res 2001; 7: 2998–3005.
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