Tacev T, Zaloudík J, Janáková L, Vagunda V
Masaryk Memorial Cancer Institute, Brno, Czech Republic.
Neoplasma. 1998;45(2):96-101.
Ninety-five squamocellular carcinomas of the uterine cervix, clinical Stages II and III, were treated by either four schedules combining 252-californium neutron-gamma-radiotherapy with different proportions of a neutron component (9, 6 and 3 Gy) or gamma-irradiation alone. Flow cytometric DNA profiles were obtainable in 72 cases before treatment and 56 cases were monitored for DNA content by flow cytometry (FCM) in weekly intervals by analysis of sequential microbiopsies for one month during and after radiotherapy. DNA aneuploidy was reduced from 40% (25/63) to 19% (9/47) one week within therapy in neutron-treated groups, but not after initial gamma-radiotherapy alone. Extinction of DNA aneuploid subpopulations occurred after neutron therapy in all remaining aneuploid tumors (9/9) during further monitoring, but only in 40% (2/5) of tumors after sole gamma-irradiation. In contrast, proliferation index by more than 50% was more often achieved in groups with a higher gamma-radiation component than after neutrons only. When all therapy-induced DNA flow cytometric events are taken together for evaluation of the effects of various radiotherapy schedules, it appears that the regimen with the maximal neutron dose may not be optimal for all tumors. It is hypothesized that the differences in the early flow cytometric DNA profiles may select the DNA aneuploid squamous cell uterine cervical carcinomas as candidates for combined neutron-brachytherapy, while highly proliferating DNA near-diploid tumors may profit more from treatment with a higher gamma-radiotherapy component. However, these early DNA flow cytometric findings need to be correlated with clinical course of the disease to validate this hypothesis, a process which will be completed at the end of the expected five-year clinical outcome in 2000.
95例临床分期为II期和III期的子宫颈鳞状细胞癌患者，接受了四种治疗方案，即252锎中子 - γ射线放疗结合不同比例的中子成分（9、6和3 Gy），或仅接受γ射线照射。72例患者在治疗前可获得流式细胞术DNA图谱，56例患者在放疗期间及放疗后一个月通过对连续的微生物活检进行分析，每周间隔一次用流式细胞术（FCM）监测DNA含量。在中子治疗组中，治疗一周内DNA非整倍体率从40%（25/63）降至19%（9/47），但仅接受初始γ射线放疗后未出现这种情况。在进一步监测期间，所有剩余的非整倍体肿瘤（9/9）在中子治疗后DNA非整倍体亚群消失，但仅接受γ射线照射的肿瘤中只有40%（2/5）出现这种情况。相比之下，γ射线成分较高的组比仅接受中子治疗的组更常使增殖指数提高50%以上。当将所有治疗引起的DNA流式细胞术事件综合起来评估各种放疗方案的效果时，似乎最大中子剂量的方案可能并非对所有肿瘤都是最佳的。据推测，早期流式细胞术DNA图谱的差异可能会选择DNA非整倍体子宫颈鳞状细胞癌作为中子近距离联合治疗的候选对象，而高度增殖的近二倍体DNA肿瘤可能从较高γ射线放疗成分的治疗中获益更多。然而，这些早期DNA流式细胞术结果需要与疾病的临床进程相关联，以验证这一假设，这一过程将在2000年预期的五年临床结果结束时完成。
