Lymphocyte radiosensitivity is a significant prognostic factor for morbidity in carcinoma of the cervix.
OBJECTIVE
To study the relationship between pretreatment peripheral blood lymphocyte radiosensitivity and morbidity following radiation therapy.


METHODS
A prospective study was carried out in which patients with carcinoma of the cervix underwent radiation therapy. Intrinsic radiosensitivity was measured on pretreatment peripheral blood lymphocytes, using a limiting dilution clonogenic assay. Late morbidity was assessed using the Franco-Italian glossary. Results were correlated in an actuarial analysis.


RESULTS
There were no correlations between the measured lymphocyte radiosensitivity (SF2) and colony-forming efficiency, patient age, tumor grade, or disease stage. For 83 patients, lymphocyte SF2 was a significant prognostic factor for the probability of developing both any (p = 0.002) and Grade 3 (p = 0.026) morbidity. In 174 patients, stage showed borderline significance as a prognostic factor for morbidity (p = 0.056). However, the type of treatment (intracavitary alone, intracavitary plus parametrial irradiation, single insertion plus whole-pelvis irradiation) was significantly associated with the probability of developing late complications (p = 0.013). There was a weak significant inverse correlation between lymphocyte SF2 and grade of morbidity (r = -0.34, p = 0.002).


CONCLUSIONS
These data highlight the importance of normal cell radiosensitivity as a factor determining radiation therapy response. They also show that peripheral blood lymphocyte SF2 is a highly significant prognostic factor for the probability of developing late radiation morbidity, and that carcinoma of the cervix is a good model for testing radiobiologic principles in the clinic.
West
C M
CM
CRC Experimental Radiation Oncology Group, Paterson Institute for Cancer Research, Manchester, United Kingdom. cwest@picr.man.ac.uk
Davidson
S E
SE
Elyan
S A
SA
Valentine
H
H
Roberts
S A
SA
Swindell
R
R
Hunter
R D
RD
D000367:Age Factors; D001918:Brachytherapy / Q000009:adverse effects; D002277:Carcinoma / Q000097:blood / Q000473:pathology / Q000532:radiotherapy*; D002470:Cell Survival / Q000528:radiation effects; D003114:Colony-Forming Units Assay; D005260:Female; D006801:Humans; D008214:Lymphocytes / Q000502:physiology / Q000528:radiation effects*; D009367:Neoplasm Staging; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D011832:Radiation Injuries / Q000209:etiology*; D011836:Radiation Tolerance; D002583:Uterine Cervical Neoplasms / Q000097:blood / Q000473:pathology / Q000532:radiotherapy*