1
|
Blomain ES, Moding EJ. Liquid Biopsies for Molecular Biology-Based Radiotherapy. Int J Mol Sci 2021; 22:11267. [PMID: 34681925 PMCID: PMC8538046 DOI: 10.3390/ijms222011267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/13/2021] [Accepted: 10/15/2021] [Indexed: 11/29/2022] Open
Abstract
Molecular alterations drive cancer initiation and evolution during development and in response to therapy. Radiotherapy is one of the most commonly employed cancer treatment modalities, but radiobiologic approaches for personalizing therapy based on tumor biology and individual risks remain to be defined. In recent years, analysis of circulating nucleic acids has emerged as a non-invasive approach to leverage tumor molecular abnormalities as biomarkers of prognosis and treatment response. Here, we evaluate the roles of circulating tumor DNA and related analyses as powerful tools for precision radiotherapy. We highlight emerging work advancing liquid biopsies beyond biomarker studies into translational research investigating tumor clonal evolution and acquired resistance.
Collapse
Affiliation(s)
- Erik S. Blomain
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA;
| | - Everett J. Moding
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305, USA;
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA 94305, USA
| |
Collapse
|
2
|
Ben-David MA, Corn BW, Evron E, Goldberg H, Pfeffer RM, Abdah-Bortnyak R, Matceyevsky D, Weinstein Y, Golan O, Sklair-Levy M. Prophylactic breast irradiation reduces background parenchymal enhancement (BPE) on MRI: A secondary analysis. Breast 2019; 49:70-73. [PMID: 31734591 PMCID: PMC7375590 DOI: 10.1016/j.breast.2019.10.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 10/07/2019] [Accepted: 10/22/2019] [Indexed: 01/01/2023] Open
Abstract
PURPOSE We recently showed that prophylactic breast irradiation (PBI) reduces the risk of contralateral breast cancer in BRCA mutation carriers undergoing treatment for early breast cancer. It has been suggested that Background Parenchymal Enhancement (BPE) may be a biomarker for increased risk of breast cancer. METHODS For participants in the trial we reviewed the MRI prior to enrollment and following radiation treatment and scored the contralateral breast for BPE and density. RESULTS Significant reduction of BPE was more commonly noted following PBI (p = 0.011) compared to the control group. CONCLUSION Reduction of BPE by PBI may contribute to its prophylactic effect.
Collapse
Affiliation(s)
- Merav A Ben-David
- Department of Radiation Oncology, Sheba Medical Center, Ramat-Gan, Israel; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Benjamin W Corn
- Shaare Zedek Medical Center, Jerusalem, Israel; Hadassah Medical School, The Hebrew University, Jerusalem, Israel.
| | - Ella Evron
- Oncology, Kaplan Medical Institute, Rehovot, Israel; Hadassah Medical School, The Hebrew University, Jerusalem, Israel
| | | | | | - Roxoliana Abdah-Bortnyak
- Oncology Division, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | | | | | - Orit Golan
- Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Miri Sklair-Levy
- Department of Radiation Oncology, Sheba Medical Center, Ramat-Gan, Israel; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| |
Collapse
|
3
|
Gargiulo S, Albanese S, Mancini M. State-of-the-Art Preclinical Photoacoustic Imaging in Oncology: Recent Advances in Cancer Theranostics. Contrast Media Mol Imaging 2019; 2019:5080267. [PMID: 31182936 PMCID: PMC6515147 DOI: 10.1155/2019/5080267] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 04/15/2019] [Indexed: 02/08/2023]
Abstract
The optical imaging plays an increasing role in preclinical studies, particularly in cancer biology. The combined ultrasound and optical imaging, named photoacoustic imaging (PAI), is an emerging hybrid technique for real-time molecular imaging in preclinical research and recently expanding into clinical setting. PAI can be performed using endogenous contrast, particularly from oxygenated and deoxygenated hemoglobin and melanin, or exogenous contrast agents, sometimes targeted for specific biomarkers, providing comprehensive morphofunctional and molecular information on tumor microenvironment. Overall, PAI has revealed notable opportunities to improve knowledge on tumor pathophysiology and on the biological mechanisms underlying therapy. The aim of this review is to introduce the principles of PAI and to provide a brief overview of current PAI applications in preclinical research, highlighting also on recent advances in clinical translation for cancer diagnosis, staging, and therapy.
Collapse
Affiliation(s)
- Sara Gargiulo
- Institute of Biostructure and Bioimaging of National Council of Research, Naples 80145, Italy
| | - Sandra Albanese
- Institute of Biostructure and Bioimaging of National Council of Research, Naples 80145, Italy
| | - Marcello Mancini
- Institute of Biostructure and Bioimaging of National Council of Research, Naples 80145, Italy
| |
Collapse
|
4
|
Boucai L, Falcone J, Ukena J, Coombs CC, Zehir A, Ptashkin R, Berger MF, Levine RL, Fagin JA. Radioactive Iodine-Related Clonal Hematopoiesis in Thyroid Cancer Is Common and Associated With Decreased Survival. J Clin Endocrinol Metab 2018; 103:4216-4223. [PMID: 30137527 PMCID: PMC6194804 DOI: 10.1210/jc.2018-00803] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 08/13/2018] [Indexed: 11/19/2022]
Abstract
CONTEXT Radioactive iodine (RAI) has been epidemiologically associated with the development of hematologic malignancies. Clonal hematopoiesis (CH) is a precursor clonal state that confers increased risk of leukemia and occurs at an elevated rate in patients with thyroid cancer relative to other solid tumors. OBJECTIVE We explore if the high prevalence of CH may be a result of RAI exposure and whether CH may be a surrogate in the association between RAI and leukemia. DESIGN CH, CH-potential driver (CH-PD), and overall survival were evaluated in 279 patients with advanced thyroid carcinoma. RESULTS The prevalence of CH in patients with thyroid cancer was 37%, and that of CH-PD was 5.2%. Age was the strongest predictor of CH and CH-PD. For every year increase in age, there was a 5% and 13% increase in the odds of CH and CH-PD, respectively. RAI dose was significantly associated with CH and CH-PD, even after adjustment for age, external beam radiation therapy, and chemotherapy. For every 10 mCi increase in the dose of RAI administered, there was a 2% and 4% increase in the odds of CH and CH-PD, respectively. Patients with CH-PD previously exposed to RAI had a significantly poorer survival, even when stratified by age (heart rate = 3.75, 95% CI = 1.23 to 11.5, P = 0.02). CONCLUSIONS RAI was associated with a high prevalence of CH, and CH is a precursor state of hematologic malignancies. The implications of this study may favor identification of CH in patients where the risks might outweigh the benefits of receiving RAI therapy for thyroid cancer.
Collapse
Affiliation(s)
- Laura Boucai
- Division of Endocrinology, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
- Correspondence and Reprint Requests: Laura Boucai, MD, MS, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, Box 313, New York, New York 10065. E-mail:
| | - John Falcone
- Weill Cornell Medical College, New York, New York
| | - Jenny Ukena
- Division of Endocrinology, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Catherine C Coombs
- Division of Hematology and Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Ahmet Zehir
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Ryan Ptashkin
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Michael F Berger
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York
- Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Ross L Levine
- Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York
- Department of Medicine, Leukemia Service, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - James A Fagin
- Division of Endocrinology, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
- Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York
| |
Collapse
|
5
|
Svendsen A, Verhoeff JJC, Immervoll H, Brøgger JC, Kmiecik J, Poli A, Netland IA, Prestegarden L, Planagumà J, Torsvik A, Kjersem AB, Sakariassen PØ, Heggdal JI, Van Furth WR, Bjerkvig R, Lund-Johansen M, Enger PØ, Felsberg J, Brons NHC, Tronstad KJ, Waha A, Chekenya M. Expression of the progenitor marker NG2/CSPG4 predicts poor survival and resistance to ionising radiation in glioblastoma. Acta Neuropathol 2011; 122:495-510. [PMID: 21863242 PMCID: PMC3185228 DOI: 10.1007/s00401-011-0867-2] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Revised: 08/15/2011] [Accepted: 08/15/2011] [Indexed: 12/05/2022]
Abstract
Glioblastoma (GBM) is a highly aggressive brain tumour, where patients respond poorly to radiotherapy and exhibit dismal survival outcomes. The mechanisms of radioresistance are not completely understood. However, cancer cells with an immature stem-like phenotype are hypothesised to play a role in radioresistance. Since the progenitor marker neuron-glial-2 (NG2) has been shown to regulate several aspects of GBM progression in experimental systems, we hypothesised that its expression would influence the survival of GBM patients. Quantification of NG2 expression in 74 GBM biopsies from newly diagnosed and untreated patients revealed that 50% express high NG2 levels on tumour cells and associated vessels, being associated with significantly shorter survival. This effect was independent of age at diagnosis, treatment received and hypermethylation of the O(6)-methylguanine methyltransferase (MGMT) DNA repair gene promoter. NG2 was frequently co-expressed with nestin and vimentin but rarely with CD133 and the NG2 positive tumour cells harboured genetic aberrations typical for GBM. 2D proteomics of 11 randomly selected biopsies revealed upregulation of an antioxidant, peroxiredoxin-1 (PRDX-1), in the shortest surviving patients. Expression of PRDX-1 was associated with significantly reduced products of oxidative stress. Furthermore, NG2 expressing GBM cells showed resistance to ionising radiation (IR), rapidly recognised DNA damage and effectuated cell cycle checkpoint signalling. PRDX-1 knockdown transiently slowed tumour growth rates and sensitised them to IR in vivo. Our data establish NG2 as an important prognostic factor for GBM patient survival, by mediating resistance to radiotherapy through induction of ROS scavenging enzymes and preferential DNA damage signalling.
Collapse
Affiliation(s)
- Agnete Svendsen
- Department of Biomedicine, University of Bergen, 5009 Bergen, Norway
| | - Joost J. C. Verhoeff
- Laboratory of Experimental Oncology and Radiobiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Heike Immervoll
- Department of Pathology, Haukeland University Hospital, 5021 Bergen, Norway
| | - Jan C. Brøgger
- Department of Neurology, Haukeland University Hospital, 5021 Bergen, Norway
| | - Justyna Kmiecik
- Department of Biomedicine, University of Bergen, 5009 Bergen, Norway
| | - Aurelie Poli
- Department of Biomedicine, University of Bergen, 5009 Bergen, Norway
- Centre de Recherche de Public de la Santé, Luxembourg, Haukeland University Hospital, Bergen, Norway
| | - Inger A. Netland
- Department of Biomedicine, University of Bergen, 5009 Bergen, Norway
| | - Lars Prestegarden
- Department of Dermatology, Haukeland University Hospital, 5021 Bergen, Norway
| | - Jesús Planagumà
- Department of Biomedicine, University of Bergen, 5009 Bergen, Norway
| | - Anja Torsvik
- Department of Biomedicine, University of Bergen, 5009 Bergen, Norway
| | | | | | - Jan I. Heggdal
- Department of Oncology and Medical Physics, University of Amsterdam, Amsterdam, The Netherlands
| | - Wouter R. Van Furth
- Department of Neurosurgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Rolf Bjerkvig
- Department of Biomedicine, University of Bergen, 5009 Bergen, Norway
- Centre de Recherche de Public de la Santé, Luxembourg, Haukeland University Hospital, Bergen, Norway
| | | | - Per Ø. Enger
- Department of Biomedicine, University of Bergen, 5009 Bergen, Norway
- Department of Neurosurgery, Haukeland University Hospital, 5021 Bergen, Norway
| | - Joerg Felsberg
- Department of Neuropathology, Heinrich-Heine-University, Düsseldorf, Germany
| | - Nicolaas H. C. Brons
- Centre de Recherche de Public de la Santé, Luxembourg, Haukeland University Hospital, Bergen, Norway
| | - Karl J. Tronstad
- Department of Biomedicine, University of Bergen, 5009 Bergen, Norway
| | - Andreas Waha
- Department of Neuropathology, University Hospital Bonn, Bonn, Germany
| | - Martha Chekenya
- Department of Biomedicine, University of Bergen, 5009 Bergen, Norway
- Translational Cancer Research Group, Jonas Lies vei 91, 5009 Bergen, Norway
| |
Collapse
|
6
|
Widłak P, Pietrowska M, Wojtkiewicz K, Rutkowski T, Wygoda A, Marczak L, Marczyk M, Polańska J, Walaszczyk A, Domińczyk I, Składowski K, Stobiecki M, Polański A. Radiation-related changes in serum proteome profiles detected by mass spectrometry in blood of patients treated with radiotherapy due to larynx cancer. J Radiat Res 2011; 52:575-581. [PMID: 21768750 DOI: 10.1269/jrr.11019] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The study aimed to detect features of human serum proteome that were associated with exposure to ionizing radiation. The analyzed group consisted of 46 patients treated with radical radiotherapy for larynx cancer; patients were irradiated with total doses in a range from 51 to 72 Gy. Three consecutive blood samples were collected from each patient: before the start, 2 weeks after the start, and 4-6 weeks after the end of radiotherapy. The low-molecular-weight fraction of the serum proteome (2,000-13,000 Da) was analyzed by the MALDI-ToF mass spectrometry. Proteome profiles of serum samples collected before the start of radiotherapy and during the early stage of the treatment were similar. In marked contrast, mass profiles of serum samples collected several weeks after the end of the treatment revealed clear changes. We found that 41 out of 312 registered peptide ions changed their abundance significantly when serum samples collected after the final irradiation were compared with samples collected at the two earlier time points. We also found that abundances of certain serum peptides were associated with total doses of radiation received by patients. The results of this pilot study indicate that features of serum proteome analyzed by mass spectrometry have potential applicability as a retrospective marker of exposure to ionizing radiation.
Collapse
Affiliation(s)
- Piotr Widłak
- Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Poggioli T, Sterpone S, Palma S, Cozzi R, Testa A. G0 and G2 chromosomal assays in the evaluation of radiosensitivity in a cohort of Italian breast cancer patients. J Radiat Res 2010; 51:615-619. [PMID: 20921829 DOI: 10.1269/jrr.10052] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Breast cancer (BC) is the most common type of malignancy in female patients and radio-treatment is the conventional therapy even if a great number of studies reported that enhanced sensitivity to ionizing radiation as measured as chromosome effects is present in a significant proportion of cancer patients, including breast cancer ones. In this study we analysed whether peripheral blood lymphocytes from sporadic BC patients and healthy subjects showed a different sensitivity to ionizing radiation and whether cytogenetic radiosensitivity may serve as a breast cancer risk biomarker. To test this hypothesis, the in vitro radiation sensitivity was measured by using both G(0) and G(2) chromosome radiosensitivity assays, on 46 subjects (23 BC patients and 23 healthy subjects). Results show that cancer patients are more radiosensitive than healthy controls and that G(2) assay could be more appropriate to define the individual radiosensitivity if compared to G(0) assay.
Collapse
Affiliation(s)
- Tommaso Poggioli
- Section of Toxicology and Biomedical Sciences, ENEA Casaccia, Rome, Italy
| | | | | | | | | |
Collapse
|
8
|
Silva P, Homer JJ, Slevin NJ, Musgrove BT, Sloan P, Price P, West CML. Clinical and biological factors affecting response to radiotherapy in patients with head and neck cancer: a review. Clin Otolaryngol 2008; 32:337-45. [PMID: 17883552 DOI: 10.1111/j.1749-4486.2007.01544.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The main aim of this article was to review the clinical and biological factors that have been shown to influence the response of the head and neck squamous cell carcinoma (HNSCC) to primary radiotherapy and briefly discuss how some of these factors could be exploited to improve outcome. DESIGN Medline based search covering 1982-2006 to identify the HNSCC literature where the effect of clinical and biological factors on locoregional control and overall survival were investigated. RESULTS Clinical factors are routinely used in management decisions. Nevertheless, identically staged tumours receiving the same treatment may have different outcomes. Biological factors such as hypoxia, proliferation and radio-sensitivity play an important role in radiation response. However, these are not currently used in practise because tests that are clinically reliable and feasible are not available. CONCLUSION High-quality translational research will allow us to develop biological tests that can be used in routine clinical practise to tailor individual treatment, with the ability to improve patient outcome further by modifying the underlying tumour biology.
Collapse
Affiliation(s)
- P Silva
- Academic Department of Radiation Oncology, The University of Manchester, Manchester, UK.
| | | | | | | | | | | | | |
Collapse
|
9
|
Ojima E, Inoue Y, Miki C, Mori M, Kusunoki M. Effectiveness of gene expression profiling for response prediction of rectal cancer to preoperative radiotherapy. J Gastroenterol 2007; 42:730-6. [PMID: 17876542 DOI: 10.1007/s00535-007-2089-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2006] [Accepted: 06/19/2007] [Indexed: 02/04/2023]
Abstract
BACKGROUND Our aim was to determine whether the expression levels of specific genes could predict clinical radiosensitivity in human colorectal cancer. METHODS Radioresistant colorectal cancer cell lines were established by repeated X-ray exposure (total, 100 Gy), and the gene expressions of the parent and radioresistant cell lines were compared in a microarray analysis. To verify the microarray data, we carried out a reverse transcriptase-polymerase chain reaction analysis of identified genes in clinical samples from 30 irradiated rectal cancer patients. RESULTS A comparison of the intensity data for the parent and three radioresistant cell lines revealed 17 upregulated and 142 downregulated genes in all radioresistant cell lines. Next, we focused on two upregulated genes, PTMA (prothymosin alpha) and EIF5a2 (eukaryotic translation initiation factor 5A), in the radioresistant cell lines. In clinical samples, the expression of PTMA was significantly higher in the minor effect group than in the major effect group (P = 0.004), but there were no significant differences in EIF5a2 expression between the two groups. CONCLUSIONS We identified radiation-related genes in colorectal cancer and demonstrated that PTMA may play an important role in radiosensitivity. Our findings suggest that PTMA may be a novel marker for predicting the effectiveness of radiotherapy in clinical cases.
Collapse
Affiliation(s)
- Eiki Ojima
- Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, 514-8507, Japan
| | | | | | | | | |
Collapse
|
10
|
Vitzthum J, Dörr HD, Meineke V. Ultraviolet B exposure could influence the interpretation of serum S100beta levels in patients with malignant melanoma. Br J Dermatol 2007; 156:772-3. [PMID: 17493078 DOI: 10.1111/j.1365-2133.2006.07737.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
11
|
Ménard C, Johann D, Lowenthal M, Muanza T, Sproull M, Ross S, Gulley J, Petricoin E, Coleman CN, Whiteley G, Liotta L, Camphausen K. Discovering clinical biomarkers of ionizing radiation exposure with serum proteomic analysis. Cancer Res 2006; 66:1844-50. [PMID: 16452246 DOI: 10.1158/0008-5472.can-05-3466] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this study, we sought to explore the merit of proteomic profiling strategies in patients with cancer before and during radiotherapy in an effort to discover clinical biomarkers of radiation exposure. Patients with a diagnosis of cancer provided informed consent for enrollment on a study permitting the collection of serum immediately before and during a course of radiation therapy. High-resolution surface-enhanced laser desorption and ionization-time of flight (SELDI-TOF) mass spectrometry (MS) was used to generate high-throughput proteomic profiles of unfractionated serum samples using an immobilized metal ion-affinity chromatography nickel-affinity chip surface. Resultant proteomic profiles were analyzed for unique biomarker signatures using supervised classification techniques. MS-based protein identification was then done on pooled sera in an effort to begin to identify specific protein fragments that are altered with radiation exposure. Sixty-eight patients with a wide range of diagnoses and radiation treatment plans provided serum samples both before and during ionizing radiation exposure. Computer-based analyses of the SELDI protein spectra could distinguish unexposed from radiation-exposed patient samples with 91% to 100% sensitivity and 97% to 100% specificity using various classifier models. The method also showed an ability to distinguish high from low dose-volume levels of exposure with a sensitivity of 83% to 100% and specificity of 91% to 100%. Using direct identity techniques of albumin-bound peptides, known to underpin the SELDI-TOF fingerprints, 23 protein fragments/peptides were uniquely detected in the radiation exposure group, including an interleukin-6 precursor protein. The composition of proteins in serum seems to change with ionizing radiation exposure. Proteomic analysis for the discovery of clinical biomarkers of radiation exposure warrants further study.
Collapse
Affiliation(s)
- Cynthia Ménard
- Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute, NIH/DHHS, Building 10, 9000 Rockville Pike, Bethesda, MD 20892, USA
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Sharma P, Kumar N, Bahadur AK, Mandal AK. Ki-67 expression in cytologic scrapes from oral squamous cell carcinoma before and after 24 gray radiotherapy--a study on 43 patients. Med Oral Patol Oral Cir Bucal 2005; 10 Suppl 1:E15-7. [PMID: 15800463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
OBJECTIVE To study the Ki-67 labeling indices in surface scrape smears from patients with oral squamous cell carcinoma before and after 24 Gray radiotherapy. STUDY DESIGN Forty three patients with histologically documented squamous cell carcinoma of the oral cavity were sampled by means of surface scrape smears prior to therapy and after receiving 24 Gray fractionated radiotherapy. These smears were stained for Ki-67 expression using the avidin biotin alkaline phosphatase technique. RESULTS Ki-67 expression was seen in an extremely small number of cells. Only 10 tumors showed positive cells, and the labeling index in them varied from 0.1 % to 0.01 %. After 24 Gray irradiation, no case showed any Ki-67 positive cells. CONCLUSIONS The overall yield of malignant cells in surface smears is low even prior to therapy and their number decreases further after irradiation. This, along with other factors including low concentration of proliferating cells on the surface of the lesion and obscuring inflammatory cells, anucleate squames, bacterial colonies and proteinaceous material could have accounted for the low labeling indices obtained. Radiation induced decline in proliferation has been described previously. The major conclusion, in balance, is that conventional oral scrape cytology may not be the optimal tool for immunocytochemical evaluation of proliferation in oral squamous cell cancer.
Collapse
Affiliation(s)
- Prashant Sharma
- Department of Pathology, Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi 2, India.
| | | | | | | |
Collapse
|
13
|
Roznovanu SL, Rădulescu D, Novac C, Stolnicu S. The morphologic changes induced by hormone and radiation therapy on prostate carcinoma. Rev Med Chir Soc Med Nat Iasi 2005; 109:337-42. [PMID: 16607796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
The morphologic changes induced by hormone and radiation therapy were evaluated in prostate biopsy and prostatectomy specimens from patients with residual prostate carcinoma. The two therapeutic methods induce changes both in the nonmalignant and malignant residual prostatic tissue. Following hormone therapy, the nonmalignant prostatic tissue showed atrophy of prostatic acini associated with fibrosis, basal cell hyperplasia, degenerative changes of the secretory epithelial cells, and a marked decrease of high-grade intraepithelial neoplasia (HGPIN). In the fragments of residual carcinoma, squamous cell metaplasia, necrosis, and necrobiosis in the foci, vacuolization of the cell cytoplasm, smaller, rare nucleoli, intraluminal crystalloids, higher Gleason score associated with a lower capsular penetration, areas of necrosis and mitoses were found. Following radiation therapy, the nontumoral prostatic tissue showed an increased number of atrophic acini, squamous cell metaplasia, and presence of atypical glands. The morphologic changes induced by radiation therapy in the residual prostatic carcinoma were characterized by an abnormal architectural structure of the glands and presence of cell atypias correlated with the biochemical lowering of serum PSA.
Collapse
|
14
|
Bhosle SM, Huilgol NG, Mishra KP. Apoptotic index as predictive marker for radiosensitivity of cervical carcinoma: Evaluation of membrane fluidity, biochemical parameters and apoptosis after the first dose of fractionated radiotherapy to patients. ACTA ACUST UNITED AC 2005; 29:369-75. [PMID: 16125335 DOI: 10.1016/j.cdp.2005.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2005] [Indexed: 11/24/2022]
Abstract
BACKGROUND This study was aimed to develop possible predictive response of cervical carcinoma in stage IIIA and B patients by evaluating the changes in physical parameter, such as, membrane fluidity, biochemical parameters, such as, intracellular calcium, antioxidant enzymes [superoxide dismutase (SOD), catalase, glutathione peroxidase (GPx)] and apoptotic cell death in cervical cancer cells from patients after treating with the first fractionated dose of 2 Gy in radiation therapy protocol. METHODS Biopsies of cervical carcinoma patients were collected before and 24h after first fractionated radiation dose of 2 Gy. Cell suspensions and tissue of cervix cancer biopsies were used to measure various physical and biochemical parameters. RESULTS AND CONCLUSIONS A negative correlation was found to exist between observed fluidity of membrane/SOD level with the degree of apoptosis in cervical cells. On the other hand, a positive correlation was observed between intracellular calcium level and percent cellular apoptosis. These results suggest that changes in membrane fluidity, SOD and calcium level were involved in the mechanism of radiation induced cervical apoptosis as measured by TUNEL assay. Moreover, apoptotic sensitivity of these cells after the first dose of radiation treatment showed a direct correlation with the radiation treatment outcome in patients after completion of radiotherapy protocol (70 Gy) in the clinic suggesting that apoptotic index may form a basis for prognosis in radiotherapy in stage III cervix cancer patients.
Collapse
Affiliation(s)
- Sushma M Bhosle
- Radiation Oncology Division, Dr. Balabhai Nanavati Hospital, Mumbai 400 056, India
| | | | | |
Collapse
|
15
|
Amundson SA, Grace MB, McLeland CB, Epperly MW, Yeager A, Zhan Q, Greenberger JS, Fornace AJ. Human in vivo radiation-induced biomarkers: gene expression changes in radiotherapy patients. Cancer Res 2004; 64:6368-71. [PMID: 15374940 DOI: 10.1158/0008-5472.can-04-1883] [Citation(s) in RCA: 184] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
After initially identifying potential biomarkers of radiation exposure through microarray studies of ex vivo irradiated human peripheral white blood cells, we have now measured the in vivo responses of several of these biomarker genes in patients undergoing total body irradiation. Microarray analysis has identified additional in vivo radiation-responsive genes, although the general in vivo patterns of stress-gene induction appear similar to those obtained from ex vivo white blood cell experiments. Additional studies may reveal correlations between responses and either diagnosis or prognosis, and such in vivo validation marks an important step in the development of potentially informative radiation exposure biomarkers.
Collapse
Affiliation(s)
- Sally A Amundson
- Center for Cancer Research, National Cancer Institute, NIH, Bethesda, Maryland 20892, USA.
| | | | | | | | | | | | | | | |
Collapse
|
16
|
Potters L, Huang D, Fearn P, Kattan MW. The effect of isotope selection on the prostate-specific antigen response in patients treated with permanent prostate brachytherapy. Brachytherapy 2003; 2:26-31. [PMID: 15062160 DOI: 10.1016/s1538-4721(03)00004-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2002] [Revised: 12/13/2002] [Accepted: 12/17/2002] [Indexed: 11/28/2022]
Abstract
PURPOSE To assess the difference in prostate-specific antigen (PSA) response kinetics in patients undergoing either (125)I or (103)Pd permanent prostate brachytherapy (PPB). METHODS AND MATERIALS Between 1997 and 1999, 333 patients underwent PPB as monotherapy. Forty-eight patients received a (125)I implant, and 285 received a (103)Pd implant. Biochemical relapse-free survival was defined by the Kattan modification of the American Society for Therapeutic Radiology and Oncology consensus, based on three PSA increases. In addition, the time to reach a PSA threshold of <or=1.0 ng/ml was noted. Log-rank testing was performed, and multivariate analysis was used to evaluate those variables associated with biochemical freedom from recurrence. RESULTS With a mean 36-month follow-up, the actuarial biochemical relapse-free survival at 4 years was 86.8%. No significant difference in biochemical relapse-free survival was noted between patients treated with (125)I and (103)Pd (p=0.417). Multivariate analysis failed to identify isotope as an independent variable to predict for biochemical relapse-free survival. The mean time for patients treated with (103)Pd to reach the threshold PSA value was 10.2 weeks, whereas it was 22 weeks for (125)I (p=0.014). When the median time to reach the PSA threshold of <or=1.0 ng/ml was used to calculate the percentage of delivered dose for each isotope relative to the prescribed dose, there was no significant difference noted between (125)I (84%) and (103)Pd (94%) (p=0.86). CONCLUSIONS Isotope selection does not appear to influence biochemical relapse-free survival in patients treated with monotherapy PPB. There was a significant difference (p=0.014) in time to reach a PSA threshold of <or=1.0 ng/ml noted between (125)I and (103)Pd. However, the percentage of delivered dose relative to the time to reach the threshold was the same between (125)I and (103)Pd. This information is important for during patients their post-PPB period.
Collapse
Affiliation(s)
- Louis Potters
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center at Mercy Medical Center, Rockville Centre, NY 11570, USA.
| | | | | | | |
Collapse
|
17
|
|
18
|
Stock RG. The role of hormonal therapy in prostate brachytherapy. Brachytherapy 2003; 2:1-2. [PMID: 15062156 DOI: 10.1016/s1538-4721(03)00011-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Richard G Stock
- Department of Radiation Oncology, Mount Sinai Medical Center, New York, NY, USA
| |
Collapse
|
19
|
Mukherjee G, Freeman A, Moore R, Devi KU, Morris LS, Coleman N, Dilworth S, Prabhakaran PS, Stanley MA. Biologic factors and response to radiotherapy in carcinoma of the cervix. Int J Gynecol Cancer 2001; 11:187-93. [PMID: 11437923 DOI: 10.1046/j.1525-1438.2001.01014.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Ionizing radiation has been used to treat cancers for a century. However, radioresistance remains a major problem in the clinic. Recent advances in the understanding of the molecular events that occur following ionizing radiation leading to DNA damage and repair, apoptosis, and cell cycle arrests suggest new ways in which the radiation response might be manipulated. Seventy-eight cases of carcinoma of the cervix of the same stage (II A and B) were analyzed retrospectively. All patients were treated with radiotherapy (RT) with a dose varying from 35 Gy to 50 Gy with 200 cGy per fraction. Subsequent to the completion of radiotherapy, all patients underwent surgery 4-6 weeks later. On histological examination of the surgical specimens, 51% of the cases (40) showed a complete response to therapy with no viable tumor cells. 49% of cases (38) had residual tumors ranging from a small focus to lesions extending through more than half the thickness of the cervical wall. p53 (mutant), bcl-2, p21 and bax proteins were studied on the paraffin sections of the biopsies (pretreatment) of those patients who failed to respond to RT and compared to similar studies on biopsies of patients who had a complete response to RT. In addition, the minichromosome maintenance (MCM) 2 proliferative marker was also done on all cases. Expression of all proteins was done using immunohistochemsitry. In the radioresistant cases, 15% (six cases) showed positivity for bcl-2 and p21, respectively, and 34% (13 cases) showed mutant p53. None of the radiosensitive tumors were positive for the above proteins. 75% of the radiosensitive tumors (30 cases) were positive for the bax antibody, whereas 81% of the radioresistant tumors (31 cases) were negative for bax. The MCM2 proliferative marker was positive in > 80% of cells in 81.5% of radioresistant tumors (31 cases) as compared to < 40% of cells that were positive in 70% of radiosensitive tumors (28 cases). The P-value for the biological markers was calculated using the chi-squared test, and was highly significant (P < 0.01) for all the parameters tested. However, there was no statistical significance by univariate analysis when the dose of radiation was analyzed with respect to the markers and the histological response. There was also no correlation between the radiation response and timing of surgery. The above data strongly suggest that bax, along with proliferative markers, could play a role in determining which tumors are likely to respond to radiation therapy. The presence of bcl-2, p21 and p53 could also be related to radioresistance of the tumors.
Collapse
Affiliation(s)
- G Mukherjee
- Department of Pathology, Kidwai Memorial Institute of Oncology, Bangalore, Karnataka, South India.
| | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Harima Y, Harima K, Shikata N, Oka A, Ohnishi T, Tanaka Y. Bax and Bcl-2 expressions predict response to radiotherapy in human cervical cancer. J Cancer Res Clin Oncol 1998; 124:503-10. [PMID: 9808425 DOI: 10.1007/s004320050206] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE The ratio of Bcl-2 to Bax expression determines survival or death following an apoptotic stimulus. In order to establish a new predictor of the outcome of treatment for human cervical carcinoma, we investigated the relationship between the expressions of the Bax and Bcl-2 proteins and the response to radiotherapy after the administration of 10.8 Gy. METHODS A total of 44 patients with histologically proven carcinoma of the uterine cervix, including three with recurrent cervical stump carcinomas, were treated with definitive radiotherapy. The presence of mutations in exons 5-8 of the p53 gene was analyzed by a single-strand conformation polymorphism analysis and DNA sequencing. RESULTS Forty patients were found to have wild-type p53, and the remaining four had mutant p53. The Bax and Bcl-2 protein expressions prior to radiotherapy did not correlate with response and survival. However, the Bax and Bcl-2 protein expressions after radiotherapy correlated with both response and survival. Bax-positive tumors showed significantly better responses than the Bax-negative tumors after 10.8 Gy radiation (P = 0.0002). In contrast, the Bcl-2-positive tumors showed significantly poorer responses than the Bcl-2-negative tumors after radiation (P = 0.002). Increased Bax expression after the 10.8 Gy radiotherapy was found to be correlated with good survival (P = 0.04). In contrast, increased Bcl-2 expression after such radiotherapy was correlated with poor survival (P = 0.002). CONCLUSION The levels of Bax and Bcl-2 expression after 10.8 Gy radiotherapy are useful prognostic markers in patients with human cervical carcinoma.
Collapse
Affiliation(s)
- Y Harima
- Department of Radiology, Kansai Medical University, Moriguchi City, Osaka, Japan.
| | | | | | | | | | | |
Collapse
|
21
|
Pillai MR, Jayaprakash PG, Nair MK. Tumour-proliferative fraction and growth factor expression as markers of tumour response to radiotherapy in cancer of the uterine cervix. J Cancer Res Clin Oncol 1998; 124:456-61. [PMID: 9750023 DOI: 10.1007/s004320050199] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study seeks to define the role of pretreatment of evaluation of tumour growth fraction in cervical cancer and its relationship to the clinical course of the disease. In addition, it also seeks to explain whether cell kinetics and growth factor expression have an association with tumour response to radiotherapy and hence could be of value in the management of patients. All pre-treatment biopsies were analysed for the tumour-proliferative compartment by evaluation of Ki67 antigen expression and argyrophilic nucleolar organiser region (AgNOR) counts. Growth factor analysis was done by analysing for expression of epidermal growth factor (EGF), epidermal growth factor receptor (EGF-R) and transforming growth factors alpha and beta (TGFalpha, TGFbeta). A total of 152 patients were evaluated and a correlation obtained between pre-treatment status of the tumour-growth-fraction-associated markers and clinical outcome following radiotherapy. Such patients were either disease-free (group 1, n=106) or with residual/recurrent disease (group 2, n=46) at a 16-month follow-up. Pre-treatment analysis of AgNOR significantly correlated to disease status after treatment (r=-0.517, P=0.0000). This may be due to an effect of cell proliferation. Lower AgNOR counts were significantly associated with recurrent/residual tumours, suggesting that increased proliferative activity may be a positive prognostic indicator. Similar results were also obtained for the other proliferation-associated marker Ki67 (r=-0.443, P=0.0000). Expression of EGF and EGF-R also showed significant pre-treatment correlations with the final disease outcome (r=0.248, P=0.031 and r=0.503, P=0.0000 respectively). Both these markers were expressed more by patients belonging to group 2. The opposite was the case for TGFalpha, where patients belonging to group 1 showed higher values (r=0.417, P=0.0001). The other growth factor investigated, TGFbeta, also showed a conspicuous differential expression in the two groups of patients (r=-0.604, P=0.0000). Group 1 patients showed mostly mild to moderate expression while most group 2 patients were negative for the growth factor. It therefore appears that tumours with high AgNOR counts and Ki67 index, along with expression of the two types of transforming growth factor (alpha and beta), responded better to radiotherapy.
Collapse
Affiliation(s)
- M R Pillai
- Division of Laboratory Medicine, Regional Cancer Centre, Kerala State, India
| | | | | |
Collapse
|
22
|
Okusaka T, Okada S, Sato T, Wakasugi H, Saisho H, Furuse J, Ishikawa O, Matsuno S, Yokoyama S. Tumor markers in evaluating the response to radiotherapy in unresectable pancreatic cancer. Hepatogastroenterology 1998; 45:867-72. [PMID: 9684148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND/AIMS Serum carbohydrate antigen 19-9 (CA 19-9) and carcinoembryonic antigen (CEA) are useful tumor markers in the diagnosis of pancreatic cancer. However, little research has shown their value for evaluating the response to radiotherapy in patients with advanced pancreatic cancer. METHODOLOGY Serial changes of serum CA 19-9 levels were studied in 34 patients with unresectable pancreatic cancer. All patients had a CA 19-9 level of 100 U/ml or greater before treatment and received radiotherapy as an initial treatment. A CA 19-9 responder was defined as a patient whose serum CA 19-9 level was reduced by more than 50% of the pre-treatment level after treatment. We investigated the relationship between CA 19-9 response and survival. We also studied serial changes of serum CEA levels in 20 patients with the level of 5 ng/ml or greater before radiotherapy, and investigated the relationship between CEA response and survival. RESULTS CA 19-9 response and CEA response were observed in seven (21%) of 34 patients and four (20%) of 20 patients, respectively. Median survival times of CA 19-9 responders and non-responders were 318 and 122 days, respectively, and median survival times of CEA responders and non-responders were 281 and 151 days, respectively. Based on results of the Cox regression analysis, the relative rates of cancer death between responders and non-responders were 0.24 (95% confidence interval, 0.08 to 0.72) in the CA 19-9 analysis and 0.19 (95% confidence interval, 0.04 to 0.84) in the CEA analysis. CONCLUSION Serum CA 19-9 may be useful tumor markers for assessing the effectiveness of radiotherapy for pancreatic cancer. Further investigations are necessary to determine the value of CEA.
Collapse
Affiliation(s)
- T Okusaka
- Department of Internal Medicine, National Cancer Center Hospital, Tokyo, Japan.
| | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Abstract
Substantial controversy surrounds our understanding of the effect of p53 status on radiation sensitivity. To assess directly the role of p53 expression on radiation sensitivity, we chose a conditional expression system using a temperature-sensitive murine p53 that permitted each cell line to act as its own control. We found that the conditional expression of wild type p53 induced cell death (both apoptotic and nonapoptotic), changes in cell cycle distribution (arrest in G1 and G2, which resulted in a marked depletion of S-phase cells and an increase in the fraction of cells in G2), and an increase in the radiation resistance of G1 cells. These counterbalancing effects resulted in no significant effect on overall radiosensitivity. These findings demonstrate that wild type p53 function can produce a variety of effects that can modulate radiation sensitivity and may explain why p53 status alone has not been a strong predictor of radiosensitivity.
Collapse
Affiliation(s)
- R C Zellars
- Department of Radiation Oncology, University of Michigan, Ann Arbor 48109-0582, USA
| | | | | | | |
Collapse
|
24
|
Herold D, Hanks G, Movsas B, Hanlon A. Postradiotherapy PSA nadirs fail to support dose escalation study in patients with pretreatment PSA values < 10 ng/ml. Radiat Oncol Investig 1997; 5:15-9. [PMID: 9303052 DOI: 10.1002/(sici)1520-6823(1997)5:1<15::aid-roi3>3.0.co;2-n] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
With three-dimensional conformal therapy, doses > 75 Gy have been delivered to the prostate with acceptable levels of morbidity; however, higher doses do appear to increase late gastrointestinal (GI) and genitourinary (GU) morbidity. Because patients with pretreatment prostate-specific antigen (PSA) values < 10 ng/ml can achieve 3-year actuarial bNED control rates of 90% after treatment with external beam radiotherapy to doses < 71 Gy, one might question the need for further dose escalation in this population. In this report, we examined the relationship between dose and PSA nadir for 90 patients with pretreatment PSA values < 10 ng/ml entered into a dose escalation study from March 1987 to October 1992. We wanted to see if nadir response data would predict a different outcome from our 3-year bNED control reports. All patients were treated with external beam radiotherapy to ICRU reporting point doses of 6,598 cGy to 7,895 cGy (median of 7,068 cGy). Minimum follow-up was 36 months (median, 47 months). Seven hundred thirty-nine posttreatment PSA nadir values were analyzed, yielding an average of 8.2 values per patient. Estimates of rates of bNED control and time to reach a posttreatment PSA of 1.0 ng/ml were calculated using the Kaplan-Meier product limit method. The log-rank test was used to evaluate differences in rates according to dose levels. Linear regression and Cox proportional hazard modeling were used to relate dose to bNED control on a continuum. Escalating doses from 66 to 79 Gy failed to increase the percentage of patients achieving nadir values < 1 ng/ml and similarly failed to increase the 3-year actuarial bNED control. Linear regression (P = .81) and the chi-square test of association (P = .23) supported the lack of a dose effect on nadir continuously and categorically, respectively, and the Cox regression model supported the conclusion that dose on a continuum has no effect on bNED control (P = .34). Furthermore, time to reach a posttreatment PSA level of 1.0 ng/ml was not statistically dependent on dose level (P = .13). Based on this study and prior reports demonstrating a dose response for late GI/GU morbidity, we question whether further dose escalation in this subgroup of patients is justified.
Collapse
Affiliation(s)
- D Herold
- Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111, USA
| | | | | | | |
Collapse
|
25
|
Grob BM, Schellhammer PF, Brassil DN, Wright GL. Changes in immunohistochemical staining of PSA, PAP, and TURP-27 following irradiation therapy for clinically localized prostate cancer. Urology 1994; 44:525-9. [PMID: 7524238 DOI: 10.1016/s0090-4295(94)80051-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To determine if tissue expression of prostate-specific antigen (PSA), prostatic acid phosphatase (PAP), and a prostate-associated monoclonal antibody (TURP-27) is retained after irradiation therapy and to compare these results with serum levels. METHODS Immunohistochemical tests were performed on prostatic tissue obtained by needle biopsy or transurethral resection prior to and following definitive irradiation therapy for clinically localized prostatic carcinoma. PSA, PAP, and TURP-27 were studied. Results were compared with serum PSA and PAP values. RESULTS All 20 preirradiation specimens stained positively for PSA and PAP; 19 of 20 stained for TURP-27. All 5 of the initial post-treatment biopsy specimens that showed recurrent tumor stained for all 3 markers. In 2 cases, staining for the 3 markers was greatly diminished. Only 8 of 15 post-treatment biopsy-negative specimens stained for all 3 markers. Six of 15 demonstrated loss of tissue expression for all 3 antigens. One specimen stained for PAP and TURP-27 but failed to stain for PSA. Serum PSA levels paralleled tissue expression in recurrent tumor specimens. However, 3 of the post-treatment biopsy-positive cases with PAP expressing tissue had normal serum PAP levels. CONCLUSIONS No cases of recurrent tumor with marker-negative tissue were identified. However, benign epithelial prostate cells appear to sustain sufficient damage from irradiation to lose the capacity to produce certain proteins. Diminished contribution of benign glands to circulating PSA, in addition to decreased expression in malignant tissues, may explain the lower than anticipated serum PSA levels in patients who progress after irradiation therapy.
Collapse
Affiliation(s)
- B M Grob
- Department of Microbiology and Immunology, Eastern Virginia Medical School, Norfolk
| | | | | | | |
Collapse
|
26
|
Shishkina VV, Chebotareva ED, Zamiatin SS, Siniuta BF, Nikolenko LN, Vlasenko OO, Iugrinova LG. [The effect of environmental factors on the concentration of tumor markers in the blood serum and on the indices characterizing thyroid function]. Lik Sprava 1994:31-35. [PMID: 7900350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Combined versus separate exposure of male organism to cesium-137 and chemical agents results in a more pronounced hyperferritinemia in the former case. In female chemists the ferritin level is dependent to a considerable extent on the menstrual cycle showing a tendency for the iron-containing protein level to decrease because of the action of a number of chemical agents. The rise of the level of cancer embryonic antigen is more readily seen in persons with high levels of cesium-137. Concentrations of carbohydrate antigen (CA-125) and mucin-like antigen are appreciably higher in female chemists incorporating cesium-137, and in those within the 30-km radius of the ChNPP. The level of thyroglobulin was raised in the chemists having a background incorporation of cesium, the liquidators of the aftermaths, and particularly in those happened to be in the 30-km zone. Each of the unfavourable factors taken separately (chemical agent or cesium-137) had lesser effect on the degree of elevation of TG content and hormone-forming function of the thyroid gland. An additional information has been obtained concerning the risk groups, which, however, serves as an indirect measure of carcinogenic effect various environmental factors exert on the organism.
Collapse
|
27
|
Boon ME, Kleinschmidt-Guy ED, Ouwerkerk-Noordam E. PAPNET for analysis of proliferating (MIB-1 positive) cell populations in cervical smears. Eur J Morphol 1994; 32:78-85. [PMID: 8086271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In diagnostic tumor pathology, immunohistochemical detection of proliferating cell populations is increasingly used. With the event of microwave-antigen retrieval it has become possible to detect proliferating cells in cervical smears staining positive for MiB-1. We report that with the PAPNET system, using neural network computing, it is possible to collect from the smears the images with epithelial fragments containing positive nuclei. We used this system for quantification of staining results. Cases with carcinoma in situ contained many epithelial fragments having a large number of positive-staining nuclei and with labelling indices of 60 +/- 16. Dysplasias were often completely devoid of cells with positive nuclei. In addition, we could not detect differences between progressive and regressive dysplasias. Automatic prescreening of immunostained smears using PAPNET is useful when it is desired to quantify staining results.
Collapse
Affiliation(s)
- M E Boon
- Leiden Cytology and Pathology Laboratory, Leiden, The Netherlands
| | | | | |
Collapse
|
28
|
Van der Poel HG, Boon ME. Microwave-antigen retrieval for proliferation analysis (MIB-1) and quanticyt karyometry of bladder washings. Eur J Morphol 1994; 32:71-8. [PMID: 8086270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Bladder washings can be used for simultaneous karyometry and proliferation analysis using MiB-1 as a proliferation marker. We analyzed 42 problem cases with a discordance between cytologic and karyometric classification (QUANTICYT), in which the karyometric classification was based on a combination of a nuclear shape parameter and DNA (2cDI). Moreover, 25 concordant cases were analyzed: 5 normal samples, 6 low-grade tumors and 7 high-grade tumors. All normal samples and all low-grade tumors had labelling indices below 10%, and all high-grade tumors over 10%. For the discordant low-grade tumors, the QUANTICYT classification correlated better with the MiB-1 labelling than the cytologic diagnosis. There was a clear correlation between 2cDI and MiB-1 labelling index. Slightly elevated MiB-1 labelling indices might have some prognostic value.
Collapse
Affiliation(s)
- H G Van der Poel
- Department of Urology, University Hospital, Nijmegen, The Netherlands
| | | |
Collapse
|
29
|
Rodrigus P, van Landeghem AA. Prostate specific antigen levels during and after external beam radiotherapy for localized carcinoma of the prostate: predictor of therapeutic efficacy. Strahlenther Onkol 1992; 168:397-401. [PMID: 1379747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
For 105 patients with locoregional carcinoma of the prostate, prostate specific antigen (PSA) levels were evaluated before, during and after external beam radiotherapy. The median follow-up is 17 months. In 51 patients (48.5%) initial PSA levels exceeded the maximum normal value of 20 ng/ml. Nine patients kept non-declining high levels just after radiotherapy. Only one of these is free of disease. Assuming PSA levels decrease exponentially during radiotherapy, a mean half-life of 62 days (median 54, SD 26 days) was calculated. Three out of five patients with a PSA half-life of more than 88 days relapsed as compared to a 8% (3/37) relapse rate in patients with a "normal" half-life. Prolonged PSA half-life suggests residual disease. PSA levels are expected to further decrease after radiation. Six months after irradiation persistent high PSA levels were found in 14/51 (27.5%) patients. Only four of them had no evidence of manifest disease. Important negative prognostic factors for disease control in our series were non-declining high levels of PSA, a PSA serum half-life exceeding 88 days and persistence of elevated PSA values longer than six months after treatment. In our opinion, PSA is a valuable marker in the follow-up of prostate cancer patients during and after radiotherapy.
Collapse
Affiliation(s)
- P Rodrigus
- Department of Radiation Oncology, Dr. B. Verbeeten Instituut, Tilburg, The Netherlands
| | | |
Collapse
|