Prognostic indicators in chemotherapy for head and neck carcinoma: alkaline phosphatase levels

Serum alkaline phosphatase (AP), total bilirubin, total protein, serum albumin, and serum glutamic oxaloacetic transaminase (SGOT) were determined in 55 patients with biopsy proven carcinoma of the head and neck prior to their induction chemotherapy with cis-platinum and bleomycin. Of the 55 patients, 40 (73%) exhibited either a complete or partial response (tumor mass decreased by over 50%) to the chemotherapy. Responses were noted more frequently in patients with elevated AP levels. Nine of the 10 patients (90%) with AP levels greater than 100 mU/ml experienced a major response; whereas, only 8 of 16 patients (50%) with AP levels less than 60 mU/ml demonstrated a favorable response to the chemotherapeutic agents. The source of the elevated AP levels has not yet been established. Possible sources include liver, bone, kidney, intestinal mucosa, or the tumor itself. Total bilirubin, total protein, serum albumin, and SGOT levels did not differentiate the responders from the non-responders as accurately as did the AP levels.