IMPACT OF RADIATION AND CHEMORADIATION WITH MITOMYCIN-C ON CELLULAR IMMUNITY OF PATIENTS WITH LOCALLY ADVANCED CERVICAL CANCER

Authors

  • Cholid BADRI Department of Radiology, Faculty of Medicine University of Indonesia

Keywords:

Cervical cancer, chemoradiation, cellular immunity, lymphocyte transformation

Abstract

OBJECTIVE: To evaluate the impact of chemoradiation therapy with Mitomycin-C (MMC) on the cellular immunity of patients with locally advanced cervical cancer compared with radiation therapy alone.
MATERIALS AND METHODS: Fifty-six patients with locally advanced cervical cancer were divided into two groups, 34 patients treated with radiation alone and 22 patients with chemoradiation. Chemoradiation was performed by adding 15 mg MMC/ m? body surface through intravenous bolus injection on the first day of external radiation and on the first day of intracavitary radiation during the radiation routinely administered. In all patients, lymphocyte transformation test was performed after completion of external radiation, in one month, and three months after full-course treatment.
RESULTS: In radiation group, a significant decrease of lymphocyte transformation index was evident after external radiation compared with pre-treatment values, i.e., from 25.82 + 14.30 % to 19.02 + 10.54 % (p = 0.08). These parameters were further decreased to 17.85 + 9.63 % in one month after full-course radiation. Although there was an increase to 18.97 + 9.29 % at three months after full-course radiation, these values were still significantly lower than the values before radiation (p = 0.015). In chemoradiation group, there was an insignificant decrease of lymphocyte transformation index after external radiation and first MMC administration, compared with the values before radiation, i.e., 19.09 + 12.66 % to 21.72 + 12.68 %. A significant decrease of these parameters to 13.68 + 8.23 % (p= 0.038) was noted at one month after fullcourse chemoradiation compared with the values before treatment. There was an increase of the parameters to 17.31 + 11.32 % after full-course chemoradiation, such that they were not significantly different from the values before treatment.
CONCLUSIONS: Chemoradiation with MMC in patients with locally advanced cervical cancer did not result in greater impact on cellular immunity than radiation alone; the parameters would even improve rapidly in three months after treatment. The factors that possibly played a part in such condition were working mechanism and interval of MMC administration, as well as rebounded overshoot phenomena of lymphocyte transformation after cytotoxic treatment.

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References

Thomas G, Dembo A, Fyles A, et al. Concurent chemoradiation in advanced cervical cancer. Gynecol Oncol 1990;38 (3): 446.

Hoppe R, Fuks Z, Strober S, Kaplan HS. The long term effects of radiation on | and B-lymphocytes in peripheral blood after regional irradiation. Cancer 1977;40:2071-78.

Meyer KK. Radiation induced lymphocyte-immune deficiency. A factor in the increased visceral metastases and decreased hormonal responsiveness of breast cancer. Arch Surg 1970;101:114-120.

Klatersky J. Infectious complications secondary to cancer chemotherapy. In: Hellmann K, Carter SK editors. Fundamentals of cancer chemotherapy. New York: Mc Graw Hill, 1987;397-405

Braun DP. Harris JE : Effects of combination chemotherapy on immunoregulatory cells in the peripheral blood of solid tumor cancer patients: correlation with rebound overshoot immune function recovery. Clin Immunol Immunopathol 1981;20:143.

Hersh EM, Mavligit G, Gutterman JU. Immunodeficiency in cancer and the importance of immune evaluation of the cancer patient. Med Clin North Am 1076; 60:623

Nowell PC. Phytohemaglutinin. An initiator of mitosis in cultures of normal human leukocytes, Cancer Res 1960;20:462-466.

Lindhal K, and Kiessling K. Mechanism of phytohemagglutinin (PHA) action. Exp Cell Res 1972;70:17-26.

Pogo BGT. Early events in lymphocyte transformation by Phytohemagglutinin. I. DNA dependent RNA polymerase activities in isolated lymphocyte nuclei, J Cell Biol 1972;53:635-641.

Anderson RE, Standefer JC, Tokuda S. The structural and functional assessment of cytotoxic inyury of the immune system with particular reference to the effects of ionizing radiation and cyclophosphamide. Brit. J. Cancer 1986;53(suppl.7):140-60.

Suhana N, Syahrum MH, Sudarmo §S, Miftahul C. Reaksi Imunitas Selular In Vitro dan Jumlah Leukosit Penderita Kanker Payudara Stadium I dan II sebelum Pengobatan. MKI 1988;38(7):319-328.

Lorvidhaya V, Tonusin A, Charoeniam V, Punpae P, Changwiwit W, Isariyodom P. Induction chemotherapy and irradiation in advanced carcinoma of the cervix. In : Azis MF, Kampono N, Sjamsudin S, editors. Cancer of the uterine cervix. .Current impact on chemoirradiation therapy. Jakarta : Department of Obstetrics and Gynaecology Faculty of Medicine University of Indonesia, 1988:47-52.

Badri C. Penggunaan Komputer Personal Dalam Dosimetri Penyinaran Intrakaviter Kanker Leher Rahim. Majalah Radiologi Indonesia 1995;2;22-27.

Gerdes J, Lemke H, Barsch H et al. Cell cycle analysis of a cell proliferation-associated human nuclear antigen defined by monoclonal antibody Ki-67. J Immunol 1984;133:1710-15.

Nakano T, Oka K. Differential values of Ki-67 index and mitotic index of proliferating cell population. An assessment of cell cycle and prognosis in radiation therapy for cervical cancer. Cancer 1993; 72:2401-8.

Badri C, Djakaria M, Sjamsudin S, Endang SRH. Growth fraction defined by Ki-67 immunostainng as a_ selection for combined treatment of radiation and Mitomycin-C in locally advanced cervical cancers. The Asean Journal of Radiology 1998;3 (IV):215-28.

Suharso P, “Phytohemagglutinine” (PHA) dan hubungannya dengan transformasi limfosit. Skripsi Sarjana FIPIA-UI, Jakarta, 1978.

Matangkasombut P, and Taravanich S: Lymphocyte Transformation in vitro. Second Regional Workshop in Immunology. Mahidol University, Bangkok, 1972.

Ghossein NA, Bosworth Jl. Immunocompetence in radiation therapy patients. Handbook Cancer Immunol 1978;4:1.

Al-Saraff M, Wong P, Sardesal S, et al. Clinical immmunologic responsiveness in malignant disease: 1. Delayed hypersensitivity reaction and the effect of cytotoxic drugs. Cancer 1970;26:262.

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Published

2023-04-10

How to Cite

1.
BADRI C. IMPACT OF RADIATION AND CHEMORADIATION WITH MITOMYCIN-C ON CELLULAR IMMUNITY OF PATIENTS WITH LOCALLY ADVANCED CERVICAL CANCER. ASEAN J Radiol [Internet]. 2023 Apr. 10 [cited 2024 Dec. 11];5(2):103-16. Available from: https://www.asean-journal-radiology.org/index.php/ajr/article/view/472

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