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Treatment with anticancer drugs and radiation often kills tumor cells by initiating a process called apoptosis. This is a biological program for cell death, usually set in motion to eliminate cells that have been in some way stressed or damaged. It probably serves to prevent the damage from being passed on to daughter cells. The bcl-2 gene is involved in control of apoptosis, while p53 is a gene that suppresses tumor formation and whose protein product only stains when in a mutant inactive form. These gene products were examined prior to treatment, along with a range of other markers, in 73 patients with head and neck cancers who received combined radiotherapy and chemotherapy with platinum drugs. This study by scientists at the University of Milan, Italy, was published in the November, 1995 issue of Clinical Cancer Research. Positive reaction for bcl-2 protein was among the variables, as were lymph nodes negative for tumor cells, good physical status, and low numbers of blood vessels supplying the tumor, that indicated a higher likelihood of remission. For prognosis of disease-free survival, bcl-2 positivity and p53 negativity, a low histology grade (grade increases with increased malignancy) and a high level of cell proliferation, were significant. Such information may help rationalize the assignment of patients to concurrent radiation/chemotherapy regimens.