Prognostic implications of tumor volume response and COX-2 expression change during radiotherapy in cervical cancer patients.
- Author:
Jae Myoung NOH
1
;
Won PARK
;
Seung Jae HUH
;
Eun Yoon CHO
;
Yoon La CHOI
;
Duk Soo BAE
;
Byoung Gie KIM
Author Information
1. Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. wonro.park@samsung.com
- Publication Type:Original Article
- Keywords:
Uterine cervical neoplasms;
Radiotherapy;
Volume response;
Cyclooxygenase-2
- MeSH:
Biomarkers;
Biopsy;
Carcinoma, Squamous Cell;
Cyclooxygenase 2;
Disease Progression;
Disease-Free Survival;
Follow-Up Studies;
Humans;
Magnetic Resonance Imaging;
Prostaglandin-Endoperoxide Synthases;
Receptor, Epidermal Growth Factor;
Tumor Burden;
Uterine Cervical Neoplasms
- From:Radiation Oncology Journal
2012;30(4):218-225
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The relationship between treatment outcomes, alteration of the expression of biological markers, and tumor volume response during radiotherapy (RT) in patients with uterine cervical cancer was analyzed. MATERIALS AND METHODS: Twenty patients with cervical squamous cell carcinoma received definitive RT with (n = 17) or without (n = 3) concurrent chemotherapy. Tumor volumes were measured by three serial magnetic resonance imaging scans at pre-, mid-, and post-RT. Two serial punch biopsies were performed at pre- and mid-RT, and immunohistochemical staining for cyclooxygenase (COX)-2 and epidermal growth factor receptor was performed. The median follow-up duration was 60 months. RESULTS: The median tumor volume response at mid-RT (V2R) was 0.396 (range, 0.136 to 0.983). At mid-RT, an interval increase in the distribution of immunoreactivity for COX-2 was observed in 8 patients, and 6 of them showed poor mid-RT tumor volume response (V2R > or = 0.4). Four (20%) patients experienced disease progression after 10 to 12 months (median, 11 months). All 4 patients had poor mid-RT tumor volume response (p = 0.0867) and 3 of them had an interval increase in COX-2 expression. Overall survival (OS) and progression-free survival (PFS) decreased in patients with V2R > or = 0.4 (p = 0.0291 for both). An interval increase in COX-2 expression at mid-RT was also associated with a decreased survival (p = 0.1878 and 0.1845 for OS and PFS, respectively). CONCLUSION: Poor tumor volume response and an interval increase in COX-2 expression at mid-RT decreased survival outcomes in patients with uterine cervical cancer.
