title: Lymphocyte radiosensitivity is a significant prognostic factor for morbidity in carcinoma of the cervix.
abstract: 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.
authors.affiliation: CRC Experimental Radiation Oncology Group, Paterson Institute for Cancer Research, Manchester, United Kingdom. cwest@picr.man.ac.uk
authors.forename: C M
authors.initials: CM
authors.lastname: West
authors.forename: S E
authors.initials: SE
authors.lastname: Davidson
authors.forename: S A
authors.initials: SA
authors.lastname: Elyan
authors.forename: H
authors.initials: H
authors.lastname: Valentine
authors.forename: S A
authors.initials: SA
authors.lastname: Roberts
authors.forename: R
authors.initials: R
authors.lastname: Swindell
authors.forename: R D
authors.initials: RD
authors.lastname: Hunter
mesh_terms: 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*