J Gynecol Oncol.  2009 Dec;20(4):215-220. 10.3802/jgo.2009.20.4.215.

Correlation between tumor volume response to radiotherapy and expression of biological markers in patients with cervical squamous cell carcinoma

• Noh JM
• Park W
• Huh SJ
• Cho EY
• Choi YL
• Lee JH
• Bae DS

• KMID: 2288585
• DOI: http://doi.org/10.3802/jgo.2009.20.4.215

Abstract

OBJECTIVE
To determine the factors associated with tumor volume response to radiotherapy (RT) in cervical cancer patients, and the relationship between the tumor volume response and alteration of the expression of biological markers during RT.
METHODS
Twenty consecutive patients with cervical squamous cell carcinoma who received definitive RT were enrolled. Tumor volumes were calculated by MRI examinations performed at the start of RT (pre-RT), at the fourth week of RT (mid-RT), and 1 month after RT completion (post-RT). Two serial punch biopsies were performed at pre- and mid-RT, and immunohistochemical staining was performed for cyclooxygenase (COX)-2 and epidermal growth factor receptor (EGFR).
RESULTS
For the pre-RT evaluation, fourteen (70%) and eleven (55%) patients showed positive immunoreactivity for COX-2 and EGFR, respectively. Among the seven patients whose median percentage residual tumor at mid-RT (V2R) was greater than 0.5, seven (100%, p=0.0515) and five (71.4%, p=0.3742) patients showed positive immunoreactivity for COX-2 and EGFR, respectively. The logistic regression analysis showed that positive immunoreactivity for both COX-2 and EGFR at pre-RT were associated with V2R (p=0.0782). For the mid-RT evaluation, eight cases showed an interval increase in the distribution of immunoreactivity for COX-2, and six out of the eight patients had a V2R greater than 0.5 (p=0.2222).
CONCLUSION
The poor mid-RT tumor response was associated with the coexpression of COX-2 and EGFR.

Keyword

Cervical cancer; Radiotherapy; Volume response; Cyclooxygenase-2; Epidermal growth factor receptor

MeSH Terms

Biomarkers
Biopsy
Carcinoma, Squamous Cell
Cyclooxygenase 2
Humans
Logistic Models
Neoplasm, Residual
Prostaglandin-Endoperoxide Synthases
Receptor, Epidermal Growth Factor
Tumor Burden
Uterine Cervical Neoplasms
Cyclooxygenase 2
Prostaglandin-Endoperoxide Synthases
Receptor, Epidermal Growth Factor

Figure

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  Fig. 1 The relationship between the pre-radiotherapy tumor volume and the percentage residual tumor volume at mid-radiotherapy.

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  Fig. 2 Representative slides with immunoreactivity for biological markers. Panel (A) (×400) is a slide with positive expression of cyclooxygenase (COX)-2, and panel (B) (×400) with negative expression of COX-2. Positive and negative expression of epidermal growth factor receptor (EGFR) is shown in Panel (C) and (D) (×200), respectively.

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