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Table 1.

Patient characteristics (N = 102).

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Fig 1.

Algorithm-based chemoradioselection treatment protocol.

CCRT, concurrent chemoradiotherapy; CDDP, cisplatin; CBDCA, paraplatin; AUC, area under the curve; and PND, planned neck dissection.

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Fig 2.

Representative pictures of anti-CD44v9-antibody immunostaining.

The staining intensity obtained in the basal cells of normal epithelium was used as a control (A). Tumor samples demonstrated strong (B), moderate (C), and weak (D) intensities relative to the control (A). Respective positive (E) and negative (F) stainings. Bar indicates 200 um.

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Fig 3.

(A) Disease specific survival curves of all patients (n = 102) according to the chemoradioselection.

(B) Disease specific survival curves based on the CD44 v9 positivity of biopsy samples (n = 60) obtained from 30 chemoradioselected (CRS) patients and 30 non-chemoradioselected (N-CRS) patients. (C) Disease specific survival curves based on the CD44 v9 positivity of biopsy samples obtained from 30 N-CRS patients.

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Fig 4.

(A) Disease specific survival curves based on the CD44 v9 positivity of surgically removed samples obtained from 72 non-chemoradioselected (N-CRS) patients.

(B) Diseasespecific survival curves of 30 N-CRS patients who had paired biopsy and surgically removed samples. The patients were divided into 2 groups according to their levels of CD44v9 expression before and after concurrent chemoradiotherapy.

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Table 2.

HRs using univariate and multivariate Cox proportional hazard model.

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Table 2 Expand

Fig 5.

Proposed roles of CD44v9-expressing CSC and non-CSC in the chemoradioselection.

(A) CD44v9-expressing non-CSCs are sensitive to CCRT. Intrinsic CD44v9-expressing CSCs (B) or CCRT-induced CD44v9-expressing CSCs (C) can survive CCRT. These CD44v9-expressing CSCs are considered to be highly invasive and metastatic. CSC, cancer stem cell; CCRT, concurrent chemoradiotherapy; CRS, chemoradioselected; and N-CRS, non-chemoradioselected.

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