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Kolotas C, Tonus C, Baltas D, Cernea M, Vogt HG, Martin T, Strassmann G, Zamboglou N. Clinical Relevance of Tumor Ploidy and Micronucleus Formation for Oral Cavity Cancer. TUMORI JOURNAL 2018; 85:253-8. [PMID: 10587027 DOI: 10.1177/030089169908500408] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims and Background To study the clinical relevance of tumor ploidy and micronucleus formation as prognostic factors. Methods and Study Design Twenty-eight patients with squamous cell carcinoma of the oral cavity were treated with primary radiochemotherapy consisting of irradiation up to 70 Gy in combination with cisplatin. Cell cycle distribution, micronucleus formation and ploidy were evaluated by flow cytometry of biopsies taken before treatment and after irradiation to 10 Gy (5 × 2 Gy). Sexteen out of 28 patients relapsed after a minimum follow-up period of two years. Results Flow cytometry of the recurrence biopsy showed hyperpentaploid (5c exceeding) cells in 13/16 (81%) of the relapsed patients. In 7 patients the hyperploid clone was not present in the flow cytometry of the primary tumors. Ploidy could retrospectively be determined also by image cytometry in archival tumor material of the pretreatment specimens. Patients with a level below 100 5c cells per 10,000 cell nuclei were shown to have a significantly better prognosis than patients with more than 100 hyperpentaploid tumor cells. The micronucleus formation was 2-5 times higher in tumors showing a good response to treatment than in carcinomas relapsing within two years. Conclusions The 5c-exceeding ratio measured by image cytometry and micronucleus formation proved to be good prognostic parameters for the clinical outcome of patients with locally advanced head and neck carcinomas.
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Affiliation(s)
- C Kolotas
- Department of Radiation Medicine, Staedtische Kliniken Offenbach, Germany.
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de Geus JL, Wambier LM, Bortoluzzi MC, Loguercio AD, Kossatz S, Reis A. Does smoking habit increase the micronuclei frequency in the oral mucosa of adults compared to non-smokers? A systematic review and meta-analysis. Clin Oral Investig 2017; 22:81-91. [PMID: 29063385 DOI: 10.1007/s00784-017-2246-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 10/10/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVES A systematic review of clinical studies to evaluate the frequency of micronuclei in the oral mucosa of smokers and non-smokers in adult patients was performed. MATERIALS AND METHODS A comprehensive search was carried out on MEDLINE via PubMeb, Scopus, Web of Science, LILACS, BBO, and Cochrane Library and SIGLE without restrictions. Dissertations and thesis were searched using the ProQuest Dissertations and Periodicos Capes Thesis Databases. We included only cross-sectional clinical trials that compared the frequency of micronuclei in the oral mucosa of smokers and non-smokers in adult patients. DATA After the removal of duplicates, 1338 articles were identified. After title and abstract screening, 35 studies remained. Eighteen studies were further excluded, whereas 17 studies remained for qualitative analysis and 16 for the meta-analysis of the primary and secondary outcomes. A significant difference in the frequency of micronuclei in smokers when compared to non-smokers was observed in the present study. CONCLUSIONS Despite the high variation in the methodology of the assessed studies, this study showed a higher frequency of micronuclei in exfoliated cells of smokers compared to non-smokers. CLINICAL SIGNIFICANCE The use of tobacco is associated with cytotoxic and genotoxic effects because a higher frequency of micronuclei in exfoliated cells of smokers was observed.
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Affiliation(s)
| | - Letícia Maíra Wambier
- Department of Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Marcelo Carlos Bortoluzzi
- Department of Stomatology, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Alessandro D Loguercio
- Department of Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Stella Kossatz
- Department of Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Alessandra Reis
- Department of Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil.
- Department of Dentistry, State University of Ponta Grossa, Carlos Cavalcanti street, 4748, Block M., 84030-900, Ponta Grossa, Paraná, Brazil.
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Evaluation of Various Nuclear Cytological Changes in Normal Buccal Mucosa and Peritumoural Area in Patients with Oral Squamous Cell Carcinoma Receiving Concomitant Chemoradiotherapy. PATHOLOGY RESEARCH INTERNATIONAL 2016; 2016:6293795. [PMID: 27148467 PMCID: PMC4842376 DOI: 10.1155/2016/6293795] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 03/30/2016] [Indexed: 01/14/2023]
Abstract
Objectives. To evaluate the role of serial cytological assay in calculating the nuclear response of contralateral normal buccal mucosa and peritumoural area of squamous cell carcinoma of oral cavity in patients receiving fractionated radiotherapy (RT) and chemotherapy. Materials and Methods. This prospective, nonrandomized study was comprised of 76 histologically confirmed cases of oral squamous cell carcinoma on cyclical chemoradiation treatment. Chemoradiosensitivity was evaluated using serial scrape smears taken before and after immediate exposure to CCRT, at 17th day of CCRT (mid of treatment), and at the end of treatment. The nuclear changes, such as multinucleation, micronucleation, karyorrhexis, karyolysis, nuclear budding, prominent nucleoli, and binucleation occurring in both irradiated cancer cells and contralateral normal buccal mucosa, had a statistically significant dose related increase with concomitant chemoradiotherapy (p < 0.05). Conclusion. We recommend regular use of serial cytological assay during CCRT as it may prove to be a valuable tool for assessment of chemoradiosensitivity and persistence of tumour/dysplastic cells after radiotherapy.
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de Geus JL, Rezende M, Margraf LS, Bortoluzzi MC, Fernández E, Loguercio AD, Reis A, Kossatz S. Evaluation of Genotoxicity and Efficacy of At-home Bleaching in Smokers: A Single-blind Controlled Clinical Trial. Oper Dent 2015; 40:E47-55. [DOI: 10.2341/14-121-c] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Objective
This single-blind controlled study evaluated the genotoxicity and efficacy of at-home bleaching in smokers and nonsmokers.
Methods
We selected 60 patients with central incisors A2 or darker: 30 smokers (experimental group) and 30 nonsmokers (control group). The bleaching was carried out with 10% carbamide peroxide for three hours a day for three weeks. The color was evaluated using a shade guide, Vita Bleachedguide 3D-Master, at baseline, during bleaching (first, second, and third weeks), and one week and one month after bleaching. Smears were obtained with a moistened wooden spatula from marginal gingiva. All the cytologic smears were stained with Giemsa solution. From each slide, 1000 cells were examined under 40× magnification and where micronuclei (MN) were located, they were examined under 100× magnification. The change in shade guide units at the different assessment periods and the frequency of MN were subjected to a two-way repeated measures analysis of variance and Tukey test (α=0.05).
Results
In both groups we detected a whitening of approximately 4 to 5 shade guide units, without color rebound after one month (p>0.05). The frequency of MN was significantly higher in the experimental group than in the control group, regardless of the bleaching treatment (p>0.001).
Conclusion
The efficacy of bleaching does not appear to be affected by the smoking habit. Additionally, at-home bleaching did not induce DNA damage to the gingival tissue during the bleaching period.
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Affiliation(s)
- JL de Geus
- Juliana L. de Geus, MS, State University of Ponta Grossa, Restorative Dentistry, Parana, Brazil
| | - M Rezende
- Márcia Rezende, MS. State University of Ponta Grossa, Restorative Dentistry, Ponta Grossa, Brazil
| | - LS Margraf
- Letícia S. Margraf, graduate student, State University of Ponta Grossa, Restorative Dentistry, Ponta Grossa, Brazil
| | - MC Bortoluzzi
- Marcelo C. Bortoluzzi, PhD, State University of Ponta Grossa, Stomatology, Ponta Grossa, Brazil
| | - E Fernández
- Eduardo Fernández, PhD, University of Chile, Restorative Dentistry, Santiago, Chile
| | - AD Loguercio
- Alessandro D. Loguercio, DDS, MS, PhD, Ponta Grossa State University, Restorative Dentistry, Ponta Grossa, Brazil
| | - A Reis
- Alessandra Reis, DDS, PhD, Universidade Estadual de Ponta Grossa, Restorative Dentistry, Ponta Grossa, Brazil
| | - S Kossatz
- Stella Kossatz, DDS, MS, PhD, Universidade Estadual de Ponta Grossa, Restorative Dentistry, Ponta Grossa, Brazil
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Bortoluzzi MC, Campagnoli EB, Milan JR, Reinheimer A, Masson M, Capella DL. Frequency of micronucleus in oral epithelial cells after exposure to mate-tea in healthy humans. Med Oral Patol Oral Cir Bucal 2014; 19:e345-9. [PMID: 24608213 PMCID: PMC4119309 DOI: 10.4317/medoral.19570] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2013] [Accepted: 11/21/2013] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the possibility of technique simplification for cytology slides in order to evaluate the frequency of micronuclei (FMic) and conduct a experiment looking to know the FMic of oral epithelial cells of healthy volunteers exposed to mate tea (Ilex paraguarariensis). MATERIAL AND METHODS This is a laboratorial and nonrandomized trial (quasi-experiment), where the nonusers subjects were exposed to mate-tea, consumed in the traditional way, two drinks, two times a day for a single week. Two cytology of exfoliated epithelial cells were obtained before and after the mate tea exposition. RESULTS The sample was composed by 10 volunteers. The age ranged from 18 to 33 years (Mean 23; SD5.5). The use of mate tea did not showed significant variation in the FMic (Wilcoxon Signed Ranks Test p= .24). CONCLUSIONS The proposed technique simplification showed to be reliable, without losses when compared to the conventional technique and with the advantage of eliminate toxic substances, becoming simple and practical tool for research in dentistry. The acute exposure to mate tea did not induce an increase of FMic in exfoliated buccal cells of healthy nondrinkers and nonsmokers subjects and may not have genotoxic effect. More human studies are needed before a conclusion can be made on the oral carcinogenic risk of mate tea to humans.
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Affiliation(s)
- Marcelo-Carlos Bortoluzzi
- School of Dentistry, Dentistry Department, Ponta Grossa State University (UEPG), Av. General Carlos Cavalcanti 4748 - CEP 84.030-900, Departamento de Odontologia, Faculdade de Odontologia, BLOCO M - Ponta Grossa - Paraná - Brasil,
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Huang Y, Hou H, Yi Q, Zhang Y, Chen D, Jiang E, Xia Y, Fenech M, Shi Q. The fate of micronucleated cells post X-irradiation detected by live cell imaging. DNA Repair (Amst) 2011; 10:629-38. [DOI: 10.1016/j.dnarep.2011.04.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2010] [Revised: 03/30/2011] [Accepted: 04/05/2011] [Indexed: 10/18/2022]
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Pathak R, Dey SK, Sarma A, Khuda-Bukhsh AR. Genotoxic effects in M5 cells and Chinese hamster V79 cells after exposure to 7Li-beam (LET=60 keV/microm) and correlation of their survival dynamics to nuclear damages and cell death. Mutat Res 2007; 628:56-66. [PMID: 17258499 DOI: 10.1016/j.mrgentox.2006.11.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2006] [Revised: 09/29/2006] [Accepted: 11/22/2006] [Indexed: 11/18/2022]
Abstract
Chinese hamster V79 cell and a cell strain M5, derived from V79 cells and reported to be relatively resistant to gamma-ray, hydrogen peroxide, and N-methyl-N-nitro-N-nitrosoguanidine (MNNG; a potent human carcinogen), were exposed to high LET (7)Li-beam (LET=60 keV/microm) at approximately 90% confluent state in the dose range of 0-1 Gy. Effects of (7)Li-beam exposure on cell survival, micronuclei induction (MN), chromosomal aberrations (CA) and apoptosis were compared in both the cell lines. A dose-dependent decline in survival for both the cell lines was noted, relatively less in M5 cells (mostly p<0.01) indicating greater radio-resistance in this strain. The MN, CA and apoptosis increased in a dose-dependent manner in both V79 and M5 cells. Significant differences in various other parameters between these two cell lines were also noted. The relative intensity of DNA ladder, which is a useful marker for the determination of the extent of apoptosis induction, was much higher in V79 cells. A good correlation between the reduction of the surviving fractions and the increase in frequencies of MN or CA or apoptosis was noted for both the cell lines.
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Affiliation(s)
- Rupak Pathak
- Department of Biotechnology, West Bengal University of Technology, Salt Lake Sector-I, Kolkata 700064, India
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Liu ZZ, Huang WY, Li XS, Lin JS, Cai XK, Lian KH, Zhou HJ. Prediction value of radiosensitivity of hepatocarcinoma cells for apoptosis and micronucleus assay. World J Gastroenterol 2006; 11:7036-9. [PMID: 16437613 PMCID: PMC4717051 DOI: 10.3748/wjg.v11.i44.7036] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the prediction value of radiosensitivity of hepatocarcinoma cells for apoptosis and micronucleus assay. METHODS Clonogenic assay, flow cytometry, and CB micronuclei assay were used to survey the cell survival rate, radiation-induced apoptosis and micronucleus frequency of hepatocarcinoma cell lines SMMC-7721, HL-7702, and HepG2 after being irradiated by X-ray at the dosage ranging 0-8 Gy. RESULTS After irradiation, there was a dose-effect relationship between micronucleus frequency and radiation dosage among the three cell lines (P<0.05). A positive relationship was observed between apoptosis and radiation dosage among the three cell lines. The HepG2 cells had a significant correlation (P<0.05) but apoptosis incidence had a negative relationship with micronucleus frequency. There was a positive relationship between apoptosis and radiation dosage and the correlation between SMMC-7721 and HL-7702 cell lines had a significant difference (P<0.01). After irradiation, a negative relationship between cell survival rate and radiation dosages was found among the three cell lines (P<0.01). There was a positive relationship between cell survival rate and micronucleus frequency (P<0.01). No correlation was observed between apoptosis and cell survival rate. CONCLUSION The radiosensitivity of hepatocarcinoma cells can be reflected by apoptosis and micronuclei. Detection of apoptosis and micronuclei could enhance the accuracy for predicting radiosensitivity.
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Affiliation(s)
- Zhi-Zhong Liu
- Institute of Liver Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China.
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Singh S, Datta NR, Krishnani N, Lal P, Kumar S. Radiation therapy induced micronuclei in cervical cancer—does it have a predictive value for local disease control? Gynecol Oncol 2005; 97:764-71. [PMID: 15943985 DOI: 10.1016/j.ygyno.2005.02.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2004] [Revised: 02/09/2005] [Accepted: 02/10/2005] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the predictive value of serial changes in micronuclei induction during external radiotherapy (EXRT) in cervical cancer with respect to local response at the end of EXRT and local disease free survival (LDFS). METHODS Twenty-five patients of squamous cell cancer of the cervix were treated by 50 Gy of EXRT delivered over 5 weeks followed by intracavitary brachytherapy. Serial cytological smears were taken from cervical growth at weekly intervals during the course of EXRT and stained by Giemsa and May-Grunwald's stain. Micronuclei induction were scored as (a) number of cells expressing micronuclei (MN), and (b) total number of micronuclei (TMN) in 1000 tumor cells from each of the serial smears. RESULTS A significant rise in micronuclei count was seen for both MN and TMN from pretreatment (week 0) to successive weeks of EXRT. For those having a near total tumor regression by end of EXRT, a significant rise in micronuclei was evident even at the end of first week of EXRT (MN: P = 0.05, TMN: P = 0.04). A superior LDFS was observed in patients showing greater than 50% increment in MN value in the first week (median survival for <50% vs. > or =50% rise: 5 months vs. not reached, P = 0.21), while it reached significance for a similar rise of TMN (median survival <50% vs. > or =50% rise: 5 months vs. not reached, P = 0.04). CONCLUSIONS The significant rise of micronuclei at the end of first week of EXRT in cervical cancers as observed from serial cytological smears could predict for a better local response and LDFS.
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Affiliation(s)
- Shalini Singh
- Department of Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Rae Barelli Road, Lucknow-226014, UP, India
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Bindu L, Balaram P, Mathew A, Remani P, Bhattathiri VN, Nair MK. Radiation-induced changes in oral carcinoma cells - a multiparametric evaluation. Cytopathology 2004; 14:287-93. [PMID: 14510894 DOI: 10.1046/j.1365-2303.2003.00059.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The aim of this study was to see whether serial cytological evaluation of various cellular abnormalities in tumours from patients receiving fractionated radiotherapy can predict radio-response in oral carcinoma. Cytological assessment was carried out in scrape smears collected prior to and during the course of radiotherapy in 68 patients with squamous cell carcinoma of the oral cavity planned for radical radiotherapy with accelerated fraction schedule. Smears were evaluated for a set of 15 radiation-induced cellular abnormalities. The relationship between the cellular alterations and the cumulative radiation dose was analysed by Kruskal-Wallis one-way anova. The results showed that among the various quantifiable changes that occur in irradiated cancer cells, karyolysis, karyorrhexis, pyknosis, cytolysis, multinucleation, micronucleation and nuclear budding show significant increase depending on the dose of radiation. The radio-resistant group of patients exhibited a lesser degree of change compared with the radio-sensitive group. This suggests that radio-resistance may be due to the defective induction of cell damage and that these cytological features may have potential use as predictive markers of radio-sensitivity in oral carcinoma.
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Affiliation(s)
- L Bindu
- Division of Cancer Research, Regional Cancer Centre Division of Cancer Epidemiology and Clinical Research, Trivandrum, India.
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Dertinger SD, Chen Y, Miller RK, Brewer KJ, Smudzin T, Torous DK, Hall NE, Olvany KA, Murante FG, Tometsko CR. Micronucleated CD71-positive reticulocytes: a blood-based endpoint of cytogenetic damage in humans. MUTATION RESEARCH-GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS 2003; 542:77-87. [PMID: 14644356 DOI: 10.1016/j.mrgentox.2003.08.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The frequency of micronuclei (also known as Howell-Jolly bodies) in peripheral blood erythrocytes of humans is extremely low due to the efficiency with which the spleen sequesters and destroys these aberrant cells. In the past, this has precluded erythrocyte-based analyses from effectively measuring chromosome damage. In this report, we describe a high-throughput, single-laser flow cytometric system for scoring the incidence of micronucleated reticulocytes (MN-RET) in human blood. Differential staining of these cells was accomplished by combining the immunochemical reagent anti-CD71-FITC with a nucleic acid dye (propidium iodide plus RNase). The immunochemical reagent anti-CD42b-PE was also incorporated into the procedure in order to exclude platelets which can interfere with analysis. This analytical system was evaluated with blood samples from ten healthy volunteers, one splenectomized subject, as well as samples collected from nine cancer patients before and over the course of radio- or chemotherapy. The mean frequency of MN-RET observed for the healthy subjects was 0.09%. This value is nearly two orders of magnitude higher than frequencies observed in mature erythrocytes, and is approximately half the MN-RET frequency observed for the splenectomized subject (0.20%). This suggests that the spleen's effect on micronucleated cell incidence can be minimized by restricting analyses to the youngest (CD71-positive) fraction of reticulocytes. Furthermore, MN-RET frequencies were significantly elevated in patients undergoing cancer therapy. Collectively, these data establish that micronuclei can be quantified in human peripheral blood reticulocytes with a single-laser flow cytometer, and that these measurements reflect the level of chromosome damage which has occurred in red marrow space.
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Bhattathiri VN. Cumulative interfraction interval analysis of time and fraction size in radiotherapy. Clin Oncol (R Coll Radiol) 2003; 15:394-9. [PMID: 14570087 DOI: 10.1016/s0936-6555(03)00165-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS Overall treatment time (OTT) and fraction size influence treatment results with radiotherapy; yet, being inversely related, it is difficult to distinguish their effect independently of each other. This paper proposes a new approach for analysing the interrelationship of time and fraction size in terms of cumulative interfraction intervals (CIFI) (i.e. intervals between non-successive fractions of radiotherapy). MATERIALS AND METHODS We analysed the influence of CIFI1-6, CIFI1-11 and OTTon tumour control by Kaplan-Meier calculation of the primary relapse-free survival (PRFS) and Mann Whitney 'U' test in 242 patients with epidermoid cancer of the buccal mucosa-gingiva-palate region treated by either 2.4 Gy/fraction (60 Gy/5 weeks) or 3.5 Gy/fraction (52.5 Gy/3 weeks). RESULTS The results showed that (1) prolongation of CIFI1-11 significantly decreased tumour control in the 2.4 Gy but not 3.5 Gy schedule: (2) 3.5 Gy schedule was superior to 2.4 Gy schedule, particularly when CIFI1-11 was prolonged (5-year PRFS 80.3% vs 30.9%); and (3) OTT did not influence either schedule. CONCLUSIONS Prolonging interfraction intervals (by treatment interruptions, weekend gaps, etc.) in the first 2 weeks (when accelerated repopulation attempts are maximal) affects treatment results with low fraction sizes but not high fraction sizes; OTT probably vicariously reflects the effect of prolonging the intervening CIFI.
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Affiliation(s)
- V N Bhattathiri
- Clinical Radiobiology Section, Department of Radiotherapy, Regional Cancer Centre, Trivandrum, India.
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Bhattathiri VN. Cumulative interfraction interval analysis of influence of time and interruptions on radiotherapy results in oral cancers. Int J Radiat Oncol Biol Phys 2002; 52:1251-6. [PMID: 11955736 DOI: 10.1016/s0360-3016(01)02795-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To present a new approach to analyze the influence of time and interruptions in fractionated radiotherapy, in terms of cumulative interfraction intervals (CIFIs), that is, the interval between nonsuccessive fractions of radiotherapy. METHODS AND MATERIALS The subjects were 142 patients with epidermoid cancer of the buccal mucosa-gingiva-palate region treated by 60 Gy in 25 fractions during 5 weeks. The influence of CIFI between the first and sixth, eleventh, sixteenth, and twenty-first fractions (CIFI(1-6), CIFI(1-11), CIFI(1-16), and CIFI(1-21), respectively), as well as overall treatment time on local control, was analyzed by Kaplan-Meier calculation of the primary relapse-free survival and Mann-Whitney U testing of the difference in various CIFIs between the tumors that recurred (recurred group) and those that did not (controlled group). RESULTS Only CIFI(1-11) influenced local control significantly, with the 5-year primary relapse-free survival rate being 67.9%, 48.4%, and 32.6% in those with CIFI(1-11) of <14, 14, and >14 days (p = 0.0181). The median CIFI(1-11) in the controlled group was significantly lower than that in the recurred group (14 days vs. 15 days; p = 0.0037). CONCLUSION Interruptions during the first 11 fractions, including planned weekend gaps, decrease the effect of radiotherapy, possibly because of successful tumor cell repopulation during the protracted interfraction intervals. The analysis of time in terms of CIFI rather than overall treatment time appears to be a promising area for research.
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Affiliation(s)
- V Narayanan Bhattathiri
- Department of Radiotherapy and Clinical Radiobiology Section, Regional Cancer Centre, Medical College PO, Trivandrum, India.
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Abstract
BACKGROUND AND PURPOSE Anaemia is known to influence prognosis of head and neck cancer patients, but how anaemia and tumour growth influences each other is not clear. The present study investigates the relation of erythrocyte and iron indices of oral cancer patients to primary tumour size (Tsize), invasiveness and lymph node involvement. MATERIALS AND METHODS The haemoglobin (Hb), erythrocyte count (RBC), packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC), Serum iron (SFe), transferrin iron-binding capacity (TIBC) and transferrin saturation (%Fe) were evaluated in 217 untreated patients with epidermoid cancer of the bucco-gingivo-palatine area. The association of erythrocyte and iron indices with sex, tumour size groups, invasion of adjacent structures and lymph node involvement, as well as the relation of SFe to Hb were analyzed. RESULTS Most of the patients were anaemic in terms of Hb (63%), RBC (43%) and PCV (48.4%) but almost all had normal or higher MCH (97.3%) and MCV (93.3%) though MCHC was less than normal in 70.7%. Normal or higher SFe was seen in nearly 70% and TIBC in 45% of patients. Hb, RBC and PCV were significantly lower in women, but there was no difference between men and women in the case of MCV, MCH and MCHC. Primary tumour size showed negative association with Hb, RBC and PCV but positive association with MCH (< 2 cm: 29.7 pg; 2-4 cm: 31.4 pg; > 4 cm: 31. 7 pg; P = 0.04) and MCHC (< 2 cm: 29.9; 2-4 cm: 31.5; > 4 cm: 32.1; P = 0.006). MCV, SFe, TIBC and %Fe did not show any relation to primary tumour size. None of the indices had any relation to invasion of adjacent structures or lymph node involvement. MCH, MCHC and MCV were not different in men and women but women had significantly lower Hb, RBC and PCV. The SFe showed poor correlation with Hb. CONCLUSIONS The negative association of Hb, RBC and PCV with tumour size is most likely due to chronic RBC destruction, probably tumour induced, with the products of haemolysis such as polyamines, glutathione, iron, etc., promoting tumour growth, and the positive association with MCH and MCHC reflects compensatory regeneration attempts by bone marrow. Lack of relation between the iron indices and tumour parameters and the poor correlation between SFe and Hb is probably due to utilization of iron by both bone marrow and tumours. Lack of difference in MCH and MCHC between men and women obviates the need of using separate cut-off values for the two sexes, unlike Hb, RBC and PCV. The study suggests that anaemia in oral cancer patients represents a tumour-host interaction and that evaluation of all erythrocyte indices should be part of research on cancer related anaemia.
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Affiliation(s)
- V N Bhattathiri
- Clinical Radiobiology Section, Department of Radiotherapy, Regional Cancer Centre, 695-011, Trivandrum, India
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Bhattathiri NV, Bharathykkutty C, Prathapan R, Chirayathmanjiyil DA, Nair KM. Prediction of radiosensitivity of oral cancers by serial cytological assay of nuclear changes. Radiother Oncol 1998; 49:61-5. [PMID: 9886699 DOI: 10.1016/s0167-8140(98)00077-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE To identify the relationship between the radiosensitivity of oral cancers and the induction of micronucleation, nuclear budding and multinucleation (polynucleation) evaluated by serial cytology during fractionated radiotherapy. MATERIALS AND METHODS Forty-four patients with epidermoid cancer of the oral cavity receiving radiotherapy (60 Gy in 25 fractions over 5 weeks) were studied. Serial scrape smears were taken from the tumour before and during radiotherapy and stained by Giemsa and the frequency of micronucleated cells (MNC), nuclear budded cells (NBC) and multinucleated cells (PNC) was evaluated by light microscopy. After a minimum follow-up period of 30 months the patients were classified as having resistant or sensitive tumours, depending on whether the primary tumour had recurred or not within that time. Within-group and between-group analysis on the induction of the above individual parameters and two combined parameters, the micro- or multinucleated cell (MPC) count and the abnormally nucleated cell (ANC) count, was done. The counts were expressed per 1000 uni-nucleated cells. RESULTS In both groups each parameter showed a statistically significant increase with dose, the increase being higher in the sensitive group. The ANC count showed the greatest increase, the mean counts before treatment and after 28.8 Gy being 24.3 and 157.8 (P < 0.0005), respectively, in the sensitive group and 21.0 and 65.2 (P < 0.0005), respectively, in the resistant group. After 28.8 Gy the sensitive tumours had significantly higher ANC (P = 0.01), MPC (P < 0.05) and PNC (P < 0.05) counts. CONCLUSION The study shows that serial cytological assay of nuclear changes (SCANCing) during radiotherapy is a potentially useful test to predict radiosensitivity. The fact that multinucleation showed the greatest relation with radiosensitivity suggests that injury to the cytokinetic apparatus is important in determining tumour radiosensitivity.
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Affiliation(s)
- N V Bhattathiri
- Department of Radiotherapy, Regional Cancer Centre, Trivandrum, India
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