Cellular immunity in patients with epidermoid cancer of the head and neck

Forty-three patients with squamous cell carcinoma of the head and neck were evaluated immunologically at various times before and after treatment. Impaired DNCB skin reactivity was found in patients with more advanced disease (Stages II-IV). In the 24 patients evaluated prior to therapy, only the mean percentages of two subpopulation T-cell tests, T-RFC29 and "active" T-RFC and mean absolute T-RFC29 per mm3 and PHA responses were significantly depressed. These depressed values could not, however, be correlated with the stage of the disease. In patients with poorly to moderatley differentiated tumors there was a significant decrease in mean percentage of active T-RFC and PHA stimulation. A marked difference in mean percentages of T-RFC29 between pretreated patients without nodal involvement (40.5 +/- 2.1) and those with this complicity (58.1 +/- 4.9) suggests that this assay may be used to detect occult nodal involvement. A comparison of the effects of surgery, irradiation and the combination of the two no patients indicated that only radiation affected any of their immune parameters. Irradiated patients demonstrated a marked decline in the mean absolute level of lymphocytes, total T-RFC and mean PHA responsiveness within one month of the termination of therapy: however, these values returned to the pretreatment level within seven months. None of the treatments was effective in "curing" the immune deficits observed in pretreatment patients.