Clinical Response Analysis of EGFR Expression During Three-Cycle Chemotherapy in Tongue Squamous Cell Carcinoma

Tongue squamous cell carcinoma (SCC) remains a significant clinical challenge due to its aggressive progression, early metastasis, and poor prognosis. This study aimed to analyze Epidermal Growth Factor Receptor (EGFR) expression and its association with clinical response during three cycles of chemotherapy in patients with tongue SCC. A cohort of ۳۳ patients treated at H. Adam Malik General Hospital, Medan, Indonesia, was evaluated using paraffin-embedded tissue samples. EGFR expression was assessed by immunohistochemistry and quantified using the Combined Positive Score (CPS) method, while treatment response was determined using the RECIST criteria across three chemotherapy cycles. Clinical management at the center involved several standard regimens for SCC, such as docetaxel, cisplatin, and ۵-fluorouracil combinations (for example, Brexel ۷۰–۷۵ mg/m², cisplatin ۵۰–۷۵ mg/m², and ۵-fluorouracil ۵۰۰–۱,۰۰۰ mg/m²), as well as several of TPF-based therapies and EGFR-targeted treatments using cetuximab (Erbitux), given either as a loading dose (۴۰۰ mg/m²) followed by a maintenance dose of ۲۵۰ mg/m² or according to cycle-based protocols. Data were analyzed using the Kruskal Wallis test due to non-normal distribution. Results showed that ۵۱.۵% (۱۷ patients) exhibited positive EGFR expression (CPS > ۱۰), while ۴۸.۵% (۱۶ patients) demonstrated negative expression. Tumor size reductions varied between lesions, with Lesion A showing greater responsiveness to chemotherapy. These findings suggest that patients with higher EGFR expression may exhibit increased sensitivity to EGFR-targeted therapies. Overall, this study highlights the prognostic value of EGFR expression in tongue SCC and supports the potential integration of EGFR-targeted agents with standard chemotherapy to improve therapeutic outcomes.

کلیدواژه ها:

clinical response ، EGFR Expression ، Three-Cycle Chemotherapy ، Tongue Carcinoma