Daukantienė Lina, Kazbarienė Birutė, Valuckas Konstantinas Povilas, Didžiapetrienė Janina, Krikštaponienė Aurelija, Aleknavičius Eduardas
National Cancer Institute, Vilnius, Lithuania.
National Cancer Institute, Vilnius, Lithuania.
Medicina (Kaunas). 2014;50(4):222-9. doi: 10.1016/j.medici.2014.09.005. Epub 2014 Oct 1.
To determine changes in reduced glutathione (GSH) and glutathione S-transferase (GST) during neoadjuvant chemotherapy followed by concurrent chemoradiation for patients with stage IIB-IIIB cervical cancer, and to evaluate their significance to the efficacy of the treatment.
According to the prospective phase II study protocol, 36 patients with stage IIB-IIIB cervical cancer were enrolled. A short course of intensive weekly neoadjuvant cisplatin and gemcitabine chemotherapy followed by concurrent weekly cisplatin and gemcitabine-based chemoradiation was administered. Blood samples for GSH, GST analysis were collected and analyzed before the start of the treatment, after neoadjuvant chemotherapy, and after the end of the chemoradiation.
A statistically significant increase in the concentration of GSH after neoadjuvant chemotherapy was identified. After chemoradiation, values of this rate significantly decreased in contrast with GSH concentration after neoadjuvant chemotherapy in cases of stage IIB, regional metastases negative patients group, patients with a positive response to treatment, and patients who had no progression of the disease during the first 2 years after treatment. Statistically significant changes in GST during the treatment were not identified; the GST concentration after chemoradiation showed a statistically significant difference in GST concentrations in terms of the progression of the disease and disease without progression.
The results suggest that changes in the concentration of GSH during the treatment of locally advanced cervical cancer might be important for the prediction of the efficacy of the treatment. Statistically significant changes in GST concentration levels during the treatment were not observed.
确定IIB-IIIB期宫颈癌患者在新辅助化疗后同步放化疗期间还原型谷胱甘肽（GSH）和谷胱甘肽S-转移酶（GST）的变化，并评估它们对治疗疗效的意义。
根据前瞻性II期研究方案，纳入36例IIB-IIIB期宫颈癌患者。给予短疗程的每周一次顺铂和吉西他滨强化新辅助化疗，随后每周同步进行基于顺铂和吉西他滨的放化疗。在治疗开始前、新辅助化疗后以及放化疗结束后采集血样进行GSH、GST分析。
新辅助化疗后GSH浓度有统计学意义的升高。在IIB期、区域转移阴性患者组、治疗反应阳性患者以及治疗后前2年疾病无进展的患者中，放化疗后该比率值与新辅助化疗后的GSH浓度相比显著降低。治疗期间未发现GST有统计学意义的变化；放化疗后的GST浓度在疾病进展和无进展方面显示出统计学意义的差异。
结果表明，局部晚期宫颈癌治疗期间GSH浓度的变化可能对治疗疗效的预测很重要。未观察到治疗期间GST浓度水平有统计学意义的变化。
